New York's 21st District (Rep. Bill Owens) (House): Rep. Bill Owens, D-N.Y., is one of the few House Democrats running in a Republican-leaning district who supported the law and won re-election. In 2010, Republicans in the district were divided, with Conservative party candidate Doug Hoffman peeling off support from the Republican nominee, Matt Doheny.
This time around, Republicans and conservatives alike are united behind Doheny, and Owens' health care vote will again play a major role in the campaign. Indeed, the National Republican Congressional Committee already blasted an attack against the first-term congressman. Expect health care to be a rallying cry for Doheny's campaign.
Montana (Governor): Despite pressure from Republicans, Democratic Attorney General Steve Bullock opted not to join the multi-state suit, explaining that doing so would only have wasted taxpayer dollars and Montana would be affected by the court's decision regardless of whether or not he joined. Bullock's bet is looking like a smart one today, especially since the effort did not result in overturning the law.
Virginia (Governor 2013): Short of Obama himself, no other political figure has been as visible in the debate over the constitutionality of the health care as Virginia Attorney General Ken Cuccinelli, who led the multi-state charge against the measure and relentlessly spoke out against it.
"This is a dark day for the American people, the Constitution, and the rule of law," Cuccinelli said, according to the Richmond Times-Dispatch. "This is a dark day for American liberty."
Cuccinelli owes his rise as a national conservative star to his spearheading of the opposition to the health care law. The high court's decision is a blow to his image that could matter ahead of his 2013 gubernatorial run -- and also any future national prospects.
In conservative circles, Cuccinelli will still enjoy hero-like status. But if he wins a primary against Lieutenant Governor Bill Bolling, he will have to explain his activism to the center of the electorate, an argument that is now more challenging to make.
Washington (Governor): Attorney General Rob McKenna, the state's most viable Republican gubernatorial candidate in decades, opposed the law's individual mandate and joined the multi-state suit against it. The fact that it was upheld dings McKenna a bit, because Democrats can point to his participation in what was ultimately a failed legal effort. Democrats also want to cast McKenna as extreme or overly partisan (he's pretty moderate) and as other conservatives across the country weigh in with expected outrage, look for them to tie him to the broader chorus.
"While we're disappointed that this close decision did not find in the states' favor with regard to the individual mandate, the country benefits from a thoughtful debate about the reach of federal power into the legal rights of the states and the personal financial decisions of all Americans," McKenna said on Thursday after the ruling was announced.
This issue will not dominate the race. The local economy and the overall records of Democratic Rep. Jay Inslee and McKenna are much more important. But polling shows this is a very close contest, so even if the health care ruling makes a marginal impact, it could be significant.