The Republican Party’s clumsy dance with health care policy is about to get even more awkward. A conservative “victory” in the King v. Burwell Supreme Court case will mean that millions of low-income people will lose their health insurance subsidies. Many of them will lose coverage as a result. This will almost certainly take much of the satisfaction out of an Obamacare court victory.

Politically, a Burwell “win” doesn’t have much upside for Republicans, who will need to deal with its aftermath at the state and federal level. Party infighting is likely, as pragmatic Republicans may want to ameliorate the hit on lower-income voters. Meanwhile, purist Republicans likely won’t budge on supporting, in any way, anything that is related to Obamacare or represents an increase in government health care spending.