So how much of an impact would a Supreme Court decision against the Affordable Care Act have on the health care debate in this fall’s elections? The answer may prove to be: Not much.

I’m not one of those who thinks a Supreme Court decision against health reform will carry any hidden silver linings for Dems. It could reinforce the narrative that Obama and Dems allowed health care to distract them from the economy, with nothing to show for it.

But it is worth pointing out that even if the law is struck down, the basic parameters of the health care debate itself will remain pretty much the same in the context of the presidential and Congressional campaigns.

And there may even be space for Dems to go on offense on the issue, even if a decision against Obamacare does carry clear negatives.

Case in point: This new ad from Heidi Heitkamp, the former North Dakota attorney general who’s now the Democratic candidate for Senate. This may be the first ad of the cycle in which a Democrat is not only aggressively defending the health law, but using it to attack the GOP opponent, in this case GOP Rep. Rick Berg:

In the ad, Heitkamp highlights her own battle with breast cancer, and says:

I would never vote to take away a senior’s health care. Or limit anyone’s care. There’s good and bad in the health care law that needs to be fixed. But Rick Berg voted to go back to letting insurance companies deny coverage to kids — or for preexisting conditions. I approved this message because I don’t ever want to go back to those days.

Whatever the court does with Obamacare, Republicans will continue to attack Democrats for having voted to cut $500 billion in Medicare (a false attack on the health law that Republicans used to great effect during the 2010 elections). Only this time, the debate over Medicare could be different. Not only has Paul Ryan doubled down on his plan to end Medicare as we know it, but it has now been embraced by the GOP presidential nominee, elevating the contrast between the parties on Medicare in the context of a presidential campaign and (if Dems have their way) making it crystal clear for voters.

What’s more, even if the law is struck down, Dems will try to highlight the popular provisions within the law that have been taken away from people, with the full support of Republicans — as Heitkamp does above. Whatever the negative impact a decision against the law has on Dems, it could refocus the conversation on the specific reforms Dems championed and will continue to push for — and highlight the GOP lack of an alternative.

Heitkamp, obviously, is very well positioned to go on offense on health care, given her brush with breast cancer. But it wouldn’t be surprising if other Dem candidates begin pressing a similar case.