How health care reform really could get repealed—and why the repercussions would go well beyond health care.

Author’s note: Oral arguments are finally over. By the end of this term, we’ll know whether the Supreme Court thinks the Affordable Care Act is constitutional—and, if not, which parts (if any) may survive. But what about the underlying legal theory? What about the claims, made by the health law's critics, that it's an unprecedented and unjustified violation of individual liberty? In late 2010, as these lawsuits were first moving through the courts, I decided to investigate that question, as both a policy and constitutional proposition. Here’s what I found:

Steven Hyder, 40, runs his own legal practice out of a shared office in downtown Monroe, Michigan, a blue-collar town south of Detroit. Mostly he handles relatively routine, low-profile work: bankruptcies, personal injury claims, that sort of thing. But recently, he became part of a much bigger case. He’s a named plaintiff in a lawsuit challenging the constitutionality of the Patient Protection and Affordable Care Act. The focus of Hyder’s suit, which was organized and written by a conservative legal organization, is the “individual mandate”—the requirement that everybody obtain health insurance or pay a fee to the government. The case is one of several moving through the federal judiciary. Sometime in the next few years, at least one of them is likely to end up before the Supreme Court.

A few weeks ago, I spoke with Hyder at his office, in order to learn more about why he had brought this case. He said his motive was straightforward. He’s opted not to carry health insurance because he doesn’t think the benefits justify the price, and he doesn’t want the government forcing him to do otherwise. Okay, I asked, but what if he gets sick and needs hospitalization? How will he afford those bills? It was a distinct possibility, he agreed, patting his waist and noting that he was a little overweight. But those potential bills would be problems for him and his hospital, he suggested, not society as a whole.

When I told him that I disagreed—that his decision to forgo health insurance meant other people would be paying his bills, via higher taxes and insurance premiums—he politely and respectfully took issue with my analysis. The discussion went back and forth for a while, but soon it became apparent that our differences went beyond the finer points of health care policy, to our most basic understanding of the rights and obligations of citizenship. “It’s a complete intrusion into my business and into my private life,” he told me. “I think it’s one big step towards a socialist society and I’m purely capitalist. I believe in supply-side economics and freedom.”

If those sentiments sound familiar, it’s because you’ve heard them a lot lately. They’re the rallying cries of the Tea Party movement and, more generally, of conservatives convinced the government has gotten out of control. So far, it’s proven more effective as a campaign slogan than a governing strategy. This week’s congressional vote on health care repeal is purely symbolic because Democrats hold the Senate and President Obama holds a veto. And even if Republicans do recapture the Senate and the White House in two years, they will likely think twice before repealing the program: While public opinion on the Affordable Care Act as a whole is divided, people remain wildly enthusiastic about its benefits.