Can you refuse a breath test with no consequences?

The exact consequences vary by state. In most states, the driver can refuse the test but will lose his license and pay a huge fine. In some states the car can be confiscated, too. In some states the police will get a court order to take the blood sample, and in that case you get the triple whammy -- the drunk driving conviction, the automatic suspension, and an angry technician sticking you with a needle.

Here is a California lawyer's opinion (see related link)

Refusing to take a chemical test after being arrested for Driving Under the Influence (DUI) in California in violation ofCalifornia V.C. Section 13353 - Refusal of Chemical Test, and carries serious consequences. The refusal may be charged as a separate offense in DUI criminal court. It also can be used to suspend or revoke driving privileges in a separate DMV action (California V.C. Section 23577 - Chemical Testing: Refusal to Take or Failure to Complete: Enhanced Penalties). And even though a refusal means there is no evidence of a driver's blood alcohol content (BAC) to introduce at the DUI trial, the fact that the person refused a chemical test can be offered against them to show "consciousness of guilt."