Published June 27, 2012
The Supreme Court ruling expected this week on the federal health care overhaul could go one of several ways -- the court could strike the law, uphold the law or come out with some ruling that splits the difference.
Here are the possible scenarios for how the court could rule:
Uphold the law
In what would be the best-case scenario for the Obama administration, the Supreme Court could uphold the entire Affordable Care Act. This means the court would rule the individual mandate -- the requirement that most Americans buy health insurance -- as constitutional.
Strike down the law
In what would be a crushing defeat for the Obama administration, the Supreme Court could knock down the entirety of the Affordable Care Act. In this case, the court would rule the individual mandate unconstitutional, and also rule that the mandate is not "severable" from the rest of the law. Meaning that, if the mandate goes down, the rest of the law goes down with it.
Strike down the mandate only
In this case, the court would rule the mandate unconstitutional, but determine that the rest of the law can stand even without it. This could cause financial problems for the insurance industry, as Democrats and Republicans alike acknowledge. The myriad consumer protections in the law are bound to increase costs for insurers -- without the mandate, there's no promise of millions of new customers to offset that cost.
Strike down the mandate, and related provisions
The court could try to address the potential financial burden on the insurance industry by striking down the mandate and two provisions tied to it. They are: A provision that prohibits insurers from refusing coverage based on pre-existing conditions, and a provision that prohibits insurers from charging extra based on medical history.
The court is also likely to rule on a provision expanding Medicaid access across the country. If struck down, this would undercut the law's ability to make health insurance more accessible and affordable. And in a seemingly unlikely scenario, the court could decide not to make any decision at all -- citing a law that bars court challenges over taxes that haven't yet been paid.