Sarah Binder considers the roadblocks:
[T]o do real damage to the future of health care reform, Republicans need to hold the House, and win the White House and (presumably) with it, the Senate. Even then, however, they will find it hard to repeal and replace, assuming that Senate Democrats exploit an effective filibuster against any such effort to deny the GOP the sixty votes they would need to succeed via the regular legislative process. My hunch is that today’s decision will be critical in bolstering Senate Democrats’ back bone to defend the law, even if they were to find themselves in the minority. Because most of the law’s popular insurance coverage protections kick in only in 2014, the window of opportunity for the GOP will be widest in 2013. After 2013, the GOP’s road to repeal would get even steeper.
Ryan Lizza, like Frum, doubts repeal is possible:
If the Supreme Court had gutted the law today by throwing out the mandate and the regulations and several of the other “non-scoreable” items, a President Romney with a G.O.P. Congress might have had a relatively easy time finishing the job of killing Obama’s law, even without sixty votes in the Senate. But today the Court did two things that make repeal of the A.C.A. nearly impossible now: it has given its not-inconsequential stamp of legitimacy to the law, and it has made the parliamentary path of repeal through Congress highly unlikely and probably impossible, at least in the near future.
Chait disagrees:
If Romney is unwilling to break faith with his base after he has already secured the nomination, and needs to command the center, then he’ll be unwilling to break faith with them immediately upon taking office. I would take the Republicans at their word that they will use their power to the absolute maximum extent, at any human cost, to avenge what they consider a monstrous and tyrannical wrong. The 2012 elections are now primarily a fight over whether health insurance is a right or a privilege, which is to say, a fight for decency.
The Dish 