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Health-law money in limbo

June 25, 2012: Carol Paris of Leonardtown, Md. demonstrates outside the Supreme Court in Washington.AP

Now that the Supreme Court has announced it will rule Thursday on President Barack Obama's 2010 health-care overhaul, one of the biggest questions that hangs over the decision is what happens to the billions of dollars already spent or pledged to carry out the law if parts or all of it are struck down, according to The Wall Street Journal.

While it is clear that funding would end eventually if the law is thrown out, there is no precedent for exactly how the money would be unwound since no law of this size has been invalidated in recent history. Legal experts predict companies may file lawsuits to recoup any money they spent tied to requirements under the law.

Many employers and health-care companies have received money under the law so far. The federal government has paid out $5 billion to companies to help cover health-insurance costs for early retirees.

The government and the pharmaceutical industry also have spent $3.7 billion between them to help pay for 5.25 million prescriptions filled by seniors, as required by the law, according to new figures released Monday.

In addition, the federal government is paying 10% bonuses to most primary-care physicians who treat Medicare beneficiaries and has awarded billions of dollars more in grants, contracts and loans to health providers to change the way they deliver health care.

Health-care providers have already absorbed costs under the law, such as discounts from the pharmaceutical industry on prescription drugs and reimbursement cuts to some doctors and hospitals that are already in effect.

Previous policy overhauls that ended up getting peeled back weren't as far along as the Affordable Care Act. Officials from prior administrations recalled dismantling a 1988 law that expanded the Medicare program significantly, when Congress repealed it a year later. And the Food and Drug Administration was forced to shut down its efforts to regulate tobacco after the Supreme Court ruled in 2000 that the agency didn't have the power to create rules to do that.

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