In order to strike down the Affordable Care act conservative justices will have to ignore not only precedent but decisions they have penned personally. It came to light very early on in the discussion that the most controversial point of the ACA, the individual mandate, is not without longstanding precedent. It was in fact the very first congress who enacted the first individual mandate during the presidency of one George Washington. It was first used to mandate that ship owners purchase health insurance for sailors aboard their vessels, talk about irony. Furthermore the first Congress enacted yet another individual mandate requiring that all able bodied men purchase a firearm. Sadly if this were instituted today it would certainly arose much less criticism then trying to insure poor people. We needn’t go back as far our forefathers (who’s advice we selectively adhere to at best, for example George Washington in his farewell address warning of entangling foreign alliances and advocating isolationism long forgotten) to find precedent for Congressional action on health care. 
The Agricultural Adjustment Act of 1938 was adopted in an attempt to stabilize the price of wheat and avoid wild fluctuations in price by controlling the amount being produced. Wild fluctuations in the market for wheat were viewed by Congress as an externality that should be mitigated by the powers delegated to Congress by the commerce clause (full text of Article 1 Section 8 appears in an earlier post on this very blog). Enter Roscoe Filburn, a wheat farmer who was producing more wheat than allowed by newly enacted quotas. Filburn argued that because the excess wheat he produced was for personal consumption and not destined for markets that the law should not apply. The Supreme Court ruled unanimously against Filburn. The rationale behind the decision was that if Filburn had not used home grown wheat he would have had to purchase his wheat from the open market. The cumulative action of agents like Filburn would circumvent the open market and therefore Congress had the right under the commerce clause to regulate activities that viewed in aggregate would have an effect on interstate commerce. A precedent was set that production of a product that was traded nationally was within Congress’  power to regulate interstate commerce.
Wickard v. Filburn was thrust into prominence again in 2005 in Gonzalez v. Raich. It was invoked in the decision to prevent marijuana cultivation for personal use in a state where cultivation was approved by a majority of voters. In the case of medical marijuana there would not be a break with precedet. An individual grower was seen as circumventing the open market thus warranting the intervention of the federal government under, yet again, the commerce clause. What made this decision more sweeping than the Wickard v. Filburn decision is that there were state laws on the books permitting the action the Supreme Court was barring, a far stronger interpretation of Congress’ power to regulate interstate commerce than was previously seen.
Today there are many familiar faces on the court who were involved in Gonzalez v. Raich. Rather than ruling with consistency of their own opinions, cognitive dissonance and a firm belief in judicial activism will afford them the ability to ignore their own opinions and in all likelihood strike down the individual mandate. 
For supporters of health care reform we should not be discouraged by the inevitable decision. It is rather a call for vigilance and resolve in enacting more meaningful legislation. While there are truly historic accomplishments in the ACA, it is far more conservative in it’s approach than healthcare reform advocates ever wanted. The individual mandate that conservatives now call unconstitutional was actually their own idea until a black guy said it. If the ACA is damaged by this decision we must use it as an opportunity to enact even more powerful legislation. Legislation that will be devoid of “unconstitutional” conservative ideas. Far more powerful legislation can be enacted with the authority granted to Congress in the commerce clause and the backing of precedent set in our history. A couple justices standing in the way find themselves standing on the wrong side of father time and the wrong side of history and nature will not allow them to block inevitable progress through judicial activism and inconsistent application of the law for the course of my far younger life. In the face of their impending demise the old guard is not interested in compromise, that is perhaps a favor we must return. It is our time now. Progress is just around the bend.