My Comment: I read in the Gainesville Sun this morning that all four GOP candidates for Cliff Stearns seat in the House of Representatives are committed to the repeal of the Affordable Care Act.

Never mind that millions of otherwise uninsured Americans will have better access to health care, that the Congressional Budget Office has said that it will not only be revenue neutral, but that it will have a positive effect, that insurance companies are rapidly coming to terms with the provisions and are figuring out it will mean more profits for them, that a number of provisions are welcomed by the population at large, and that folks like me who paid huge premiums for health insurance will see reductions since before we were paying not just for our own coverage but that of someone else as well.

Never mind, Obama is an idiot and anything he’s for, we’re against. Talk about having your head where the sun doesn’t shine.

By Edward Luce of the Financial Times

During the bitterest phase of the healthcare debate in 2009, Jim DeMint, a Republican senator, said he would turn defeat of the bill into “Obama’s Waterloo”. Little could anyone imagine that Chief Justice John Roberts – a hero to people such as Mr DeMint – would ride in to save the day for the president.

Last week’s 5-4 Supreme Court ruling did not turn President Barack Obama into the Duke of Wellington, the victor of Waterloo (though Chief Justice Roberts did a good impression of Marshal Blücher, the duke’s Prussian saviour). Nor did Obamacare’s Republican opponents suddenly see themselves as Napoleon’s defeated troops.

Neither side believes the epic healthcare struggle is over; rather, it increasingly looks like a war of attrition. This holds true both for the politics of Obamacare, which is as acidic as ever, and also for implementation of what is a mind-bogglingly complex law. If a law’s worth is judged by whether it can survive and then change things for the better, it is too soon to claim victory.

Last week America’s third branch of government tossed the healthcare grenade back to the first and second branches. Neither Mr Obama nor his Republican challenger Mitt Romney want to turn the upcoming election into a referendum on healthcare. Mr Romney wants to play down the fact that he has mapped out only the first half of the pledge to “repeal and replace” Obamacare. Mr Obama does not want to advertise his authorship of a law that remains widely unpopular.

But the law will nevertheless face a crossroads in November. If Mr Obama wins, it will survive; and if Mr Romney wins, it will come under possibly fatal assault.

Without 60 votes in the Senate, Mr Romney would have difficulty repealing it in full. Only measures that have a direct fiscal impact can be passed by a simple 51-49 majority.

Happily for Mr Romney, that would include the most unpopular bits, such as the fine that people who forgo insurance would have to pay, which Chief Justice Roberts last week helpfully reclassified as a “tax” (making it constitutional, in his eyes, rather than desirable). If he is wise, Mr Romney would retain the most popular features of Obamacare, such as the ban on insurance companies denying coverage to those with pre-existing conditions. Even a fully Republican-controlled Congress would be hard-pressed to get rid of that. But the “tax”, which is the wellspring of Obamacare, would probably disappear under a Romney administration. Much else would then unravel.

What if Mr Obama wins? The law then faces a different category of problems. First, it only comes into effect in 2014 and few states are anywhere near to setting up the insurance exchanges they are required to create under the law. Indeed, roughly half of them – those with Republican governors and attorneys-general – remain bitterly opposed to the exchanges and most other features of the law.

Last week the Supreme Court gave them wiggle room when it said states could reject the part of the law that expands the pool of people eligible for Medicaid subsidies. Unlike Medicare, which is a national programme for the elderly, Medicaid is administered by the states. It is also one of the main vehicles by which Obamacare would reduce the number of uninsured Americans (which today stands at roughly 50m).

Some states, such as Rick Perry’s Texas, are likely to make the most of that new loophole. This could sharply reduce the estimated 30m who would get insurance if Obamacare were implemented in full. But even if all states adopted all the law’s measures with joy in their hearts, it would be many years before Americans saw real benefits. In other words, Obamacare will remain vulnerable until the next election at least.

According to the Congressional Budget Office, 20m-23m of the bill’s beneficiaries – the large majority – will obtain coverage only after 2016. Nor is the law likely to be wildly popular by then. By the end of Mr Obama’s second term, the proportion of Americans who will be uninsured – now at more than one in seven – will not yet have fallen sharply. It would be rash to assume the six out of seven who do have insurance will feel more positive by then. They may well feel worse.

Given that there will be multiple criteria on deciding who qualifies for a sliding scale of subsidies, and given that the law’s interpretation may vary considerably from state to state, forecasts of Obamacare’s impact range wildly. Some believe it will slow US healthcare inflation and reduce costs for everyone. Others do not. But most assume it will do little to slow the rate at which employers are opting out of providing health insurance for their employees.

Indeed, it is more likely to accelerate employer flight. With or without Obamacare, Americans will continue to move into a brave new world where they will increasingly have to rely on their own wits – and the integrity of their public regulators – to get good and affordable healthcare.

These are a lot of ifs. And it does not yet feel like the American public has made a final choice on the future of US healthcare. If put into practice, Obamacare would turn America’s byzantine healthcare system into something more humane and hopefully less expensive. It would also make it even more byzantine. Within the foreseeable future, however, it seems unlikely it would radically transform things.

Last week Mr Obama won a famous battle. He was right to celebrate. But the war is still some way off from a conclusion.