White House anxiously awaits Supreme Court ruling on 'Obamacare' While the White House will put on a brave face regardless of the decision, an adverse ruling will be a major political blow and would confirm Republican accusations that "Obamacare" represents an unprecedented, and illegal, power grab by the federal government. "If Obamacare is not deemed constitutional, then the first three and a half years of this president's term will have been wasted on something that has not helped the American people," Mitt Romney, the Republican presidential candidate, said yesterday. At the heart of the decision is the legality of the "individual mandate," the clause in Mr Obama's law that forces all Americans who can afford it to purchase health insurance. By compelling young and healthy people into the insurance market, the White House believes it will be able to push down the cost of insurance premiums for all. The mandate is being contested by 28 Republican states, who sued the Obama administration claiming that it had no right to force people into insurance programmes. "It is the constitutional issue of our time," Greg Abbott, the Attorney General of Texas, told the Daily Telegraph. It will define the future arc of the United States Constitution and at the same time it is a decision of immeasurable economic impact for workers, employers and the economy. The court has a number of options before it. Justices could either strike down or uphold the law in its entirety, or reach a partial verdict that would strike down the mandate, but leave the remainder of the law in place. If the mandate were struck down the remaining provisions of the law - reforms of insurance laws and subsidies for the poorest - would return to Congress, where politicians would decide whether it was possible to still implement them. The court could also decide to delay a decision until 2014, when the mandate comes into force. Not since the Supreme Court effectively handed George W Bush the presidency after the disputed 2000 election have Americans paid so much attention to the cloistered workings of their high court. "Everyone in the United States is going to be watching this closely," said Monica Haymond, a 23-year-old whose Vietnam veteran father, Chuck, was unable to get health insurance after returning from the war after being exposed to Agent Orange. Her two unemployed sisters are among the 32 million Americans without health insurance. Today, they are on a path towards coverage but face an uncertain future should the law be overturned. "This is personal for everyone, because everyone will know someone without care or be directly impacted themselves," Ms Haymond said. The healthcare reforms - known formally as the Patient Protection and Affordable Care Act - were the result of a long and difficult political struggle that dominated much of Mr Obama's first year in the White House. Having pledged as a candidate to make "healthcare affordable to every single American," Mr Obama reached the Oval Office in 2009 with no detailed plan of how to solve a policy question that has vexed presidents as far back as Harry Truman. To the frustration of his liberal allies, Mr Obama essentially left the intricacies of the policy to Congress. In a bid to secure some Republican backing, Democrats moved ever further from an NHS-style service and eventually settled on the idea of the individual mandate, a proposal first made by a conservative group in the 1990s. Republicans fought the law at every stage accusing the White House of orchestrating a "takeover" of healthcare by federal bureaucrats. Sensing Mr Obama's political weakness on the increasingly chaotic reforms, one Republican senator warned that the bogged-down policy would be the President's "Waterloo." Many of the President's senior aides believed he squandered time and political capital when he should have focused on employment and the economy. The law's eventual passage in March 2010 played a major role in the spawning of the Tea Party, the conservative anti-government movement, and today remains deeply divisive. A recent Rasmussen poll found that 54 per cent of voters favoured its repeal compared to 39 per cent who wanted it to stay in place.