But he could instead lash out against the court's majority-as he did in the Citizens United case upholding free speech for corporations-and insist on an even larger role in health care for Washington. Perhaps he would advocate a "public option" where government competes with private and not-for-profit health-insurance companies, hospital consortiums and the like.

The president has very little room to maneuver. His approval rating on how he is handling "health care policy" in the latest Gallup Poll is only 41%. Just 39.2% of Americans favor ObamaCare, according to Huffington Post Pollster's summary of the latest polls. And the RealClearPolitics average of recent surveys shows a majority (51.7%) favor the measure's repeal while 40.7% oppose repeal.