2)  It is possible that the Supreme Court could rule that the individual mandate is unconstitutional and therefore, the law would not be able to stand on its’ own without it. Why? Unless everyone in the U.S. buys health insurance and pays their applicable premiums, the system will not be able to pay for the “unhealthy” people that will use the system to a greater extent than the “healthy” people. In short, the healthy pay for the sick. The law won’t work any other way.

If the law is repealed in whole, technically it never existed in the first place. That means all insurance requirements will disappear including the medical loss ratio, mandatory coverage for children with pre-existing conditions, etc. The seniors would also suffer as their prescription benefit rebates would be eliminated.

This would be a legal nightmare and set off a firestorm of lawsuits. The insurance carriers would sue the federal government to recover huge losses from changes made to comply with the law in the first place. Pharmaceutical companies would follow suit to recover the billions in fees they have paid to make the necessary changes.

While the United States would dodge a federally controlled health care system (what a mess that could be), we would pay a monumental opportunity cost with the wasted billions that have been spent for nothing. The national healthcare system would still be out of control and future leaders would have almost no chance of passing any meaningful reform in the near future. No one wants to go through this again if it doesn’t work.

This is a possible, but unlikely outcome

3)  The Supreme Court might also decide that the individual mandate is unconstitutional AND allow the government’s request to overturn two key provisions of the law: Guaranteed issue health insurance that would require the insurers to cover everyone equally without regard to pre-existing conditions or medical history. Community Rating which makes premiums for health insurance policies equal for everyone.

If the mandate is struck down, this would ensure that the health insurance system would continue somewhat as it used to be before healthcare reform. It has been made clear that the Supreme Court will not likely decide which parts of the law are related to the individual mandate. That will be someone else’s job.