How quickly would new benefits gained under the law go away?
Exactly how people would be impacted by the law being overturned would vary across the country, experts say. According to Wright, “Insurance plans have adapted to meet certain consumer protection standards under the health reform law, and would have to abide by the contracts they’re in now.” When the time comes for those plans’ annual renewals, however, most insurers would likely revert to their old ways.
States will have some flexibility, too. “If the whole law is overturned it’s up to [insurance] carriers and state regulators to decide what to keep in place and what not,” says Blumberg. Many states have legislation in place to enforce rules of the Affordable Care Act, which could help to maintain some of the benefits already gained, such as stronger insurance appeals processes or the requirement that insurers spend at least 80% of the premiums they collect on medical care.
Although there are limits to what states can do without federal guidance and funding, Wright adds: “I think there might be some states ... that will go forward with some [consumer] protections regardless of what the federal government does.”
What if just the individual mandate is struck down?
If only the mandate is struck down, Americans will no longer be required to buy health insurance, but insurers would still be required to sell a plan to any and all customers, regardless of their health condition.
In this scenario, consumer protections already gained under the law will remain in place. The state-based health insurance exchanges -- online marketplaces where people will be able to shop and compare and buy an insurance plan -- will continue to be developed and will open for business by 2014.
Companies with more than 50 employees will still required to provide workers with insurance or pay a fine. And the federal government will still provide subsidies to help people who qualify pay for a health plan starting in 2014. The Medicaid program will expand to cover more people with low incomes.