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U.S. President
Barack Obama’s most ambitious undertaking is facing two kinds of
trouble, with both the Congress and now the courts threatening his
overhaul of the American health system.

This week a judge
in Virginia state ruled that the Obama plan, which would force
Americans to buy health insurance, is unconstitutional. Other judges
have upheld its constitutionality, so the issue probably won’t be
settled until it reaches the Supreme Court.

That could take up to two years, but the president’s plan will face a different attack almost immediately.

Congressional elections last month changed the balance of power in Washington.

The Republicans who officially take office in January say they’ll try to repeal the plan.

They could also
simply vote to withhold funding. Under U.S. law, if the Congress won’t
pay for the plan, the president can’t implement it.

Right now, only
early elements of the enormous reform have begun to take effect. There
are years left before it’s scheduled to be fully implemented.

Between the courts and the Congress, that leaves a lot of time for things to go wrong for the president.