Who Will Be the Winners and Losers When Supreme Court Rules on Healthcare Reform?

When President Barack Obama signed The Patient Protection and Affordable Care Act in 2010, both opponents and supporters predicted that eventually the U.S. Supreme Court would be in a position to rule on the landmark legislation -- and that its ruling would come before the 2012 presidential election. That scenario appears to be playing out, as the high court today announced it would hear a challenge to the law, one of Obama's signature domestic policy achievements (or missteps, depending on your point of view) following his 2008 election. Oral arguments will be heard in March 2012 and a decision is expected by June 2012.

Since the law was passed there have been more than 20 challenges to it filed around the country, all focused on the individual mandate provision that requires all Americans to buy health insurance coverage or pay a fine. Four federal appeals courts have ruled on some of these cases; two of these upheld the law.

The process will play out this way, according to The New York Times:

The court's decision to step in had been expected, but Monday's order answered many questions about just how the case would proceed. Indeed, it offered a roadmap toward a ruling that will help define the legacy of the Supreme Court under Chief Justice John G. Roberts Jr. … The Supreme Court agreed to hear appeals from just one decision, from the United States Court of Appeals for the 11th Circuit, in Atlanta, the only one so far striking down the mandate. The decision, from a divided three-judge panel, said the mandate overstepped Congressional authority and could not be justified by the constitutional power "to regulate commerce" or "to lay and collect taxes." … On Monday, the justices agreed to decide not only whether the mandate is constitutional but also, if it is not, how much of the balance of the law … must fall along with it.

Obviously the stakes are extremely high, with the high court's ruling having the potential to affect everything from the 2012 elections to Chief Justice Roberts' standing to health insurers' business strategies -- not to mention the public's access to healthcare and healthcare coverage. In fact, insurers may not be cheering challenges to the individual mandate requirement, as this provision would create more potential customers (as well as, presumably, competitors) -- and more customers mean more business.

Katherine Burger is Editorial Director of Bank Systems & Technology and Insurance & Technology, members of UBM TechWeb's InformationWeek Financial Services. She assumed leadership of Bank Systems & Technology in 2003 and of Insurance & Technology in 1991. In addition to ... View Full Bio