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What’s next for ObamaCare?

President Barack Obamspeaks East Room White House WashingtThursday June 28 2012 after Supreme Court ruled his health care legislation. (AP

President Barack Obama speaks in the East Room of the White House in Washington, Thursday, June 28, 2012, after the Supreme Court ruled on his health care legislation. (AP Photo/Luke Sharrett pool)

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Updated: August 2, 2012 10:25AM

Just because the Supreme Court has ruled doesn’t mean the fight for President Obama’s health care plan is over.

Republicans say the ruling has energized their base to defeat Obama and repeal the law.

“Our mission is clear: If we want to get rid of ObamaCare, we’re going to have to replace President Obama. My mission is to make sure we do exactly that,” Obama’s Republican opponent, Mitt Romney, said in a Capitol Hill news conference shortly after The Supreme Court issued its ruling Thursday.

Obama campaign manager Jim Messina likewise told Obama fans and donors in an e-mail that the Nov. 6 election will determine whether the health care plan survives: “It’s been a good day. But this is a three-step process: 1. Pass historic health care reform. Check. 2. Get affirmation from the highest court in the country. Check. Step three? Win the damn election,” Messina wrote.

Then he asks for a donation.

Officials in both camps used Thursday’s ruling to try to raise money and motivate supporters.

Americans for Prosperity, a corporate-funded Political Action Committee working to defeat Obama, created a new ad based on the court’s ruling and will spend $9 million airing it in nine states including Wisconsin, Iowa and Minnesota.

With just bare majorities in both houses and a Republican president, they could wipe out ObamaCare, the group’s president, Tim Phillips, said.

“If you’re an American citizen and you want to see this legislation stopped before it gets any further, then that means the House and the Senate, and then most likely a new president, because if Americans want that, repeal is the only option,” he said.

ObamaCare promises to be an issue not just in the presidential and congressional campaigns but in local campaigns in all 50 states, where legislatures must now grapple with creating health insurance exchanges — alternative markets for people who don’t get health care through their employers but earn enough to price them out of Medicaid.

“Every state is going to be weighing the impact on their taxpayers,” said Patty Schuh, spokeswoman for Illinois State Senate Republican Leader Christine Radogno, who participated in a National Conference of State Legislatures conference call held Friday with legislative leaders around the country.

Republicans in Illinois, as in other states, have resisted moving forward with setting up the exchanges, and are not showing new interest since Thursday’s reading.

Even some downstate and suburban Democratic legislators in Illinois have told their leaders they would not like to run for re-election having voted to approve the exchanges as part of “ObamaCare” — still a dirty word to some voters.

Gov. Quinn may find himself pressured to create the exchanges through an executive order, though so far he is still hoping the legislature will pass a bill.

“We’ve already been working on this issue,” Quinn said Thursday. “We do want our legislators to pass a law with respect to health insurance exchanges.”

Illinois Republican Party Chair Pat Brady said Quinn shouldn’t hold his breath.

“Quinn has announced he’s going ahead, but I don’t think there’s going to be much support on the Republican side for doing that,” Brady said. “I know it has motivated our base for the congressional races. People do want a health care solution but they don’t want more taxation.”

Republicans are reveling in the irony that in order to pass it, Democrats had to argue that the penalty — $695 a year or more — for not buying insurance under the plan was not a tax — but then they had to argue it was a tax to pass the constitutionality test before the Supreme Court.

Chief Justice John Robert seized on the government’s secondary argument that if the penalty failed to pass constitutionality under the Commerce Clause, it could be constitutional under the power to tax in his ruling upholding the health care plan.

“Obama’s health care law is actually one of the largest tax increases in history,” the new AFP television ad charges.

Added Brady: “This is a big middle class tax increase.”

“ObamaCare” was so unpopular in the 2010 election that it helped fuel the Republican takeover of the House of Representatives.

Romney argues the plan will raise taxes on the American people by $500 billion.

Obama and the Congressional Budget office say it will actually save money by lowering the cost of health care.

Romney says up to 20 million Americans will lose their current health care insurance because employers will offload them onto cheaper government plans.

Obama says no Americans will lose their current health care insurance and up to 30 million Americans who have no insurance now will finally get insurance under the plan.

Both sides will put millions of dollars behind arguing their side of the story in television commercials between now and Nov. 6.

While polls have shown “ObamaCare” unpopular with large swatches of voters, Obama’s supporters point out that voters like many components of ObamaCare when polled about them individually, such as people under 26 able to stay on their parents’ health plans, and people with pre-existing conditions not being turned away from health insurance.

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