What difference does it make if you have to wear leg irons or handcuffs made of iron, rather than steel? None.
What difference does it make if you are forced to buy health insurance due to a monetary penalty, rather than due to its being regulated as an item of commerce? None.
The Supreme Court decision was predictable, since going along with Congress is the norm. Torturing language was predictable, since that is the norm. Torturing the Constitution was predictable, since that is the norm.