WASHINGTON (AP) — Some are already anticipating the Supreme Court's ruling on President Barack Obama's health care law as the "decision of the century." But the justices are unlikely to have the last word on America's tangled efforts to address health care woes. The problems of high medical costs, widespread waste, and tens of millions of people without insurance will require Congress and the president to keep looking for answers, whether or not the Affordable Care Act passes the test of constitutionality.
With a decision by the court expected this month, here is a look at potential outcomes >>
Q: What if the Supreme Court upholds the law and finds Congress was within its authority to require most people to have health insurance or pay a penalty?
A: That would settle the legal argument, but not the political battle.
The clear winners if the law is upheld and allowed to take full effect would be uninsured people in the United States, estimated at more than 50 million.
Q: On the other hand, what if the court strikes down the entire law?
A: Many people would applaud, polls suggest.
Taking down the law would kill a costly new federal entitlement before it has a chance to take root and develop a clamoring constituency, but that still would leave the problems of high costs, waste, and millions uninsured.
Q: What happens if the court strikes down the individual insurance requirement, but leaves the rest of the Affordable Care Act in place?
A: Individuals would have no obligation to carry insurance, but insurers would remain bound by the law to accept applicants regardless of medical condition and limit what they charge their oldest and sickest customers.
Studies suggest premiums in the individual health insurance market would jump by 10 percent to 30 percent.
Q: What if the court strikes down the mandate and also invalidates the parts of the law that require insurance companies to cover people regardless of medical problems and that limit what they can charge older people?
A: Many fewer people would get covered, but the health insurance industry would avoid a dire financial hit.
Insurers could continue screening out people with a history of medical problems; diabetes patients or cancer survivors, for example.
Q: What happens if the court throws out only the expansion of the Medicaid program?
A: That severely would limit the law's impact because roughly half of the more than 30 million people expected to gain insurance under the law would get it through the expansion of Medicaid, the federal-state health insurance program for low-income people.
But a potentially sizable number of those low-income people still might be eligible for government-subsidized private insurance under other provisions. Private coverage is more expensive to subsidize than Medicaid.
Q: What happens if the court decides that the constitutional challenge is premature?
A: The wild card, and least conclusive outcome in the case, probably also is the most unlikely, based on what justices said during the arguments.
No justice seemed inclined to take this path, which involves the court's consideration of a technical issue.
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