In the past few weeks, the Supreme Court decided the ultimate fate of the new healthcare reform law passed by Obama in 2010. In a few more weeks, Americans will have a better idea of the ramifications of their decision. There are four likely outcomes of this landmark decision and each will decide the fate of an entire industry. Get ready….

1)  The Supreme Court could uphold the law as is and before the published oral arguments, this was the most likely outcome.  Kennedy posed serious questions in the oral arguments which have led many to believe he is leaning toward repealing the law in total. This may or may not be the case since Kennedy has surprised us in the past. He’s more or less the swing vote since most of the other Justices have already made their opinions clear.

If they support the individual mandate, the implementation of the law would continue and States that have procrastinated will need to begin the process of building the health insurance exchanges and required benefits demanded by the law.

If this happens, the Department of Health & Human Services will issue more regulations on federal subsidies, penalties on employers for non-compliance, requirements on insurance contracts, etc. Let’s not forget that this is an election year so many of the changes are moving at a snail’s pace so as not to throw a monkey wrench in Obama’s chances of reelection.

If the law holds and the Democrats maintain control of the Senate and/or Obama wins his re-election bid, it’s highly likely that the law will be permanent. If the Republicans control the House and Senate and Mitt Romney wins the presidency, he will attempt to repeal the law or make major cuts through budget reconciliation before 2014 when most of the law is set to be implemented.

Based on preliminary discussions of the Supreme Court, I doubt there will be either a total repeal of the law or full implementation as intended by Obama.  More than likely, certain parts will be changed and each will have its’ own significant ramifications on healthcare in the U.S.