The anti-reform forces lose - and predictably, they go hysterical
I am not a lawyer and I thank God for that, but frankly, only a lawyer (or a political obsessive) could seriously treat the "purchase" of health care in the same light as the "purchase" of broccoli. And as the concept of health care did not exist in 1776, the notion that it is unconstitutional is about as helpful as to declare that the Moon landings were unconstitutional.
To me, this has the same feel as the American unwillingness or incapacity to contemplate serious legal reform - such as the introduction of a system of Administrative Justice such as most Code Napoleon countries have - and admit that new areas of life and experience have arisen. On the one hand, the monstrous complexity and private-only nature of Obamacare makes it unlikely to succeed in the long run; on the other, if the Republicans imagine that there is a majority for what America has now in the way of healthcare, they are living on the Moon.
The worst thing from my point of view is that while an Obama victory would mean a clash of State and Church not seen in a free country since the Combes government in France, on the other hand the Church's social doctrine has no friends among the Republicans and would mean that any alliance with them to resist Obama and his cohort of Church-hating harridans such as Sebelius and Pelosi would be dangerous and deceptive. Plus, the Republicans have seen fit to choose the worst possible candidate... at this point, I can't see a positive outcome.