For President Obama and Democrats, the politics of health-care reform haven't been pretty.
Not only do polls still show that more Americans believe the overall health-care law passed in 2010 is a bad idea than good idea, Democrats paid a deep price for passing the reform.
In the '10 midterms -- waged over the health-care law, the stimulus, and the state of the economy -- Republicans picked up 63 House seats, six Senate seats, and several governor's mansions. It was a rout.
But the early significance of today's 5-4 Supreme Court decision upholding the health-care law is that political price wasn't in vain.
Make no mistake: The Supreme Court overturning the health-care would have been a body blow for the president and his party. All the negotiations, the arm-twisting, the speeches, and the compromises would have been for naught.
For Obama, his chief domestic achievement -- the biggest since the LBJ years -- is upheld.
For congressional Democrats -- even those who were ousted in 2010 -- they have a major legislative accomplishment to tout.
How the Supreme Court's health-care decision plays out in the 2012 presidential election remains a mystery. It could energize conservatives angered by the ruling. It could fire up Democratic voters. Or it could, as our NBC/WSJ co-pollsters have suggested, actually change public opinion about the health-care law.
It's also unclear if the legislation, in the long run, ends up bending health care's cost curve (as Democrats claim it will), or if it ends up raising premiums and costs (as Republicans claim).
But here's what we can say: The court's ruling today -- by a narrow 5-4 decision -- preserves Democrats' domestic-policy achievement for the history books.