Conservatives are still mad about the New Deal, even though it worked to pull the country out of the Great Depression. They’re still miffed about women suffrage, the Civil Rights bill and Roe v. Wade. In fact any movement forward giving more people more rights and greater acceptance is a point of contention with conservatives. Gay rights is framed as Christians losing their rights to vilify whomever they want. Women not being forced to pay for birth control out-of-pocket is the government restricting the freedom of religion institutions to dictate policy to the government.
The legal theory currently in vogue in conservative circles holds that the Constitution’s vision of “a central government with limited power” — to use Judge Vinson’s phrase — permits the government to establish a single-payer health-care system that every American pays into through payroll taxes and that wipes out the private insurance industry but forbids the government from administering a regulated market in which individuals purchase private insurance plans and pay a penalty if they can afford coverage but choose to delay buying it until they’re sick. There’s a chance conservatives will come to seriously regret this stratagem. I think it’s vanishingly unlikely that the Supreme Court will side with Judge Vinson and strike down the whole of the law. But in the event that it did somehow undermine the whole of the law and restore the status quo ex ante, Democrats would start organizing around a solution based off of Medicare, Medicaid, and the budget reconciliation process — as that would sidestep both legal attacks and the supermajority requirement.