Anarchism And The Constitution

So the Patient Protection and Affordable Care Act (Obamacare) is constitutional, according to the Supreme Court. Does it actually conform to the United States Constitution? And does that question actually matter to anarchists? I’d argue “no” on the first question, but I think the latter is a more important question if we are to be effective in building institutions and relationships that serve our interests and crowd out the state’s monopoly on legitimacy.