Not in their wildest imaginations could pundits have predicted this outcome from the Supreme Court on the Patient Protection and Affordable Care Act (also known as Obamacare). Those who did, could have made a lot of money with the long odds on this outcome. 5-4, yes, and even 5-4 to uphold Obamacare; Justice Anthony Kennedy was suspected to be the swing vote. But 5-4 upholding Obamacare with Chief Justice John Roberts joining Justices Breyer, Ginsburg, Kagan and Sotomayor? Wow.

Was Chief Justice Roberts trying to protect the court from accusations of being activist or partisan? An elected Congress passed the law, Roberts wrote in his majority opinion, and it was entitled to “the full measure of deference owed to federal statutes.”

Many are describing this as a huge victory for President Obama. Washington Post writer Chris Cillizza said "For much of the past two years, Obama and Democrats have played defense on health care — losing the message war to Republicans on what the law will and won’t do. Now, Obama can use the Court decision as a jumping off point to take the offensive on all of the good things he believes were in the law that got glossed over in the political debate over it."

In a statement after the Supreme Court decision, Obama said "if you're one of the more than 250 million Americans who already have health insurance, you will keep your health insurance - this law will only make it more secure and more affordable." The president added that "Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent's health care plans - a provision that's already helped 6 million young Americans. And because of the Affordable Care Act, seniors receive a discount on their prescription drugs - a discount that's already saved more than 5 million seniors on Medicare about $600 each."

The Supreme Court decision delivered a victory for the president, but will it make it easier for him to win in November? It serves as a reminder of legislation that was passed virtually entirely by Democrats against the objections of millions of Americans. Republicans used Obamacare as the core issue to their advantage in 2010, and they will certainly try to do the same this year. However, Republicans would be making a mistake if they think it will be enough to win by saying a newly elected GOP president (Mitt Romney) and Republican majorities in House and Senate will repeal Obamacare.

Affordability and accessibility to health care is a very important issue to most Americans. The question is has the passage of Obamacare resulted in more affordable health care? Will Obamacare deliver better quality and greater affordability? If not, what is a better alternative? Can we have Obamacare without creating more debt than the 15.8 trillion + we have currently, debt which exceeds the Gross Domestic Product? We need an open debate on how best to deliver health care that is more affordable, does not further increase our already too high national debt, and covers more Americans without sacrificing quality, and I think the Supreme Court decision greatly increases the likelihood of more open and substantive debate.