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Court adjourned. What’s next?

By Jay MacDonald · Bankrate.com
Friday, March 30, 2012
Posted: 2 pm ET

This week, President Barack Obama's landmark health care reform met its critics on the nation's ultimate legal stage, the U.S. Supreme Court. As early as Friday afternoon, the justices may vote thumbs up or thumbs down on parts or all of the Affordable Care Act, though their decision is not expected to be made public until late June.

So what happens now?

Until such time as the court releases its decision, health care reform remains the law of the land. That means changes that have already occurred to your health insurance plan, such as preventive mammograms and colonoscopies without co-pays or deductibles, will remain in effect. Similarly, the elimination of lifetime limits on coverage still applies. For those on Medicare, preventive services at no cost as well as prescription discounts to close the "doughnut hole" continue.

If the court rules that the Affordable Care Act is constitutional, the larger infrastructure changes would proceed unimpeded, including state health exchanges and the requirement that uninsured Americans obtain minimum health insurance beginning in 2014.

If the Affordable Care Act is tossed out in total, an estimated 10 to 15 million uninsured Americans that health care reform was designed to insure would remain without health insurance, as many as 16 million low-income people could remain ineligible for Medicaid and the Medicare prescription drug discounts would disappear.

Those with pre-existing conditions who have been insured under temporary "high-risk pools" until 2014 when health care reform would have barred discrimination against them may find themselves without coverage unless their state chooses to maintain the pool.

In addition, federal law would no longer require insurance companies to cover the 2.5 million young adults under age 26 who have been allowed to remain on their parents' health insurance policy under health care reform.

If the court were to uphold the Affordable Care Act but strike down the mandatory insurance provision, the rest of health care reform would roll out largely unimpeded. However, without the prospect of an additional 30 million new customers, and lacking the ability to charge higher premiums or deny those with preexisting conditions, health insurance rates would likely rise an additional 10 to 30 percent, according to Insurance Journal.

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