On the other hand, Obama was to provide a subsidy, but not to create a direct requirement. In this Presidential Election also the same issue has gained prominence after the verdict given by Supreme Court in favour of PPACA. Earlier Obama tried to convince people that it is not a tax. The Supreme Court confirmed that the PPACA is a tax, but at the same time it upheld the Act. This has boosted up both the Democrats and the Republicans in their campaigns. The Republicans now argue strongly that Obama has duped the Americans in the name of Obamacare. It is a taxation on the people. On the other hand, the Democrats highlight that even the Supreme Court verdict did not go against the Obamacare.

Earlier, twenty-eight states, numerous organizations, and a number of private citizens filed actions in federal court challenging the consititutionality of the Patient Protection and Affordable Care Act (PPACA). But on June 28, 2012, the Supreme Court upheld the majority of the law. People earning less than four times the poverty line ($92.200 per year for a family of four) will receive tax credits to subsidize their purchase of insurance. Medicaid eligibility is expanded to include those earnings up to 133% of the poverty line. 

The two chambers of Congress have had detailed discussion for one year on the Act till it was signed into law by Obama on March 23, 2010. It is now referred to as Obamacare. According to many of Obama’s opponents in the election, healthcare law is bad policy for patients, doctors, healthcare providers, and administrators, small businesses and the middle class. The Law introduces as many as 21 new taxes on the middle class. People are now apprehensive of the fact that the implementation of the PPACA will make hiring of new employees difficult. The Republicans in the House of Representatives voted to repeal the PPACA and the Democrats criticized for giving vote in support of the repeal measure. The argument in favour of the repeal of the PPACA is that average New York senior will apparently have to spend over $700 more for prescription drugs if the Act is repealed.

The proposal of the Democrats is that instead of trying to repeal the law, Republicans should work with them to improve it. Some Republicans at the time of passing the PPACA joined the Democratic colleagues, but strangely enough the House Republicans have voted to repeal the PPACA. The Supreme Court verdict will dampen the spirit of the Republicans who voted 33rd time. For the Democrats the move to repeal the Act is nothing more than political show off. Thus the Election campaign in the US reaches its peak over the PPACA issue in the context of the recent verdict of the Supreme Court against the repeal. 239 Republicans and five Democrats supported the “Repeal of Obamacare Act”.

It is undeniable that the PPCA is not at all popular and the Americans resent the way the law was passed. It violates the democratic spirit of America. It is draconian. The Democrats however, argue that the efforts to repeal the law will distract the attention of the people from many important issues, like the economy and job creation. According to the Republicans, the consequences of the Supreme Court verdict are so significant and so serious to the economy, to jobs and to the middle class, which has many problems as it places a dozen new tax increases on middle class Americans. It places new mandates on small businesses and levies penalties which burden Upstate businesses and drain capital from growth. Additionally, the law has not lowered health care premiums.

However, the Republicans should not forget that they themselves had introduced similar reform proposals in the 1990s. In 1993 Senator John Chafee introduced the Health Equity and Access Reform Today Act which contained a "Universal Coverage" requirement with a penalty for non-compliance. In 1994 the Consumer Choice Health Security Act was also introduced by Don Nicles and the Act also contained an individual mandate with a penalty provision. So the Supreme Court verdict will not bring a majority of people against the Democrats. The Republicans are not in a position to challenge the Supreme Court verdict and get the mandate of the people so easily. They have not yet been able to show any better alternative. American people are still not sure of the consequences in spite of all that is said against the PPACA. By making it a political issue, the basic argument has been lost and its gravity is lessened in the eye of the common people.