As the country awaits and debates the Supreme Court's pending decision on health care reform, about the only thing insurers, providers and patients can agree on is the need for clarity.

The court's decision, expected within the month and perhaps as soon as today, could give direction to a health care system that has been in a holding pattern since challenges to the law's constitutionality were heard in March.

Some aspects of the Affordable Care Act that passed in 2010 have already launched, such as extended coverage for young adults on their parents' insurance. Others, like the more controversial requirement for all Americans to buy insurance, would take effect in 2014. Most states are waiting on the court's move to start organizing insurance markets as called for by next year.

"Everybody is ready for this decision to come down," said Ryan Barker, director of health policy for the Missouri Foundation for Health. "Regardless of what the decision is, we need to move forward."

The ruling is certain to produce a torrent of reaction and election-year posturing no matter what the decision. Both political parties have been preparing for the possible outcomes, distributing talking points and laying contingency plans for piecemeal legislation if all or part of the law is struck down.

Some experts believe that the potential of a split decision striking down the individual insurance mandate while leaving other portions of the law intact would trigger an especially chaotic political situation.

"It would be a colossal mess, even if we assume good faith on the part of our elected officials," remarked Gregory Magarian, a law professor at Washington University. "As a practical matter, it would be almost the worst of all political worlds."

Insurance companies have rushed to ease fears about the more popular aspects of the law. Several of the industry's major players have vowed to continue covering dependents until age 26 and free preventive care such as immunizations, regardless of the court's decision.

"Health plans' top priorities are providing peace of mind and continuity of coverage to their beneficiaries," said Karen Ignagni, president of America's Health Insurance Plans, in a statement. "No matter what the Supreme Court decides, individuals and families should rest assured that their current coverage will remain in effect."

What's less clear is how much the cost of insurance premiums will change if any or all of the law is tossed out.

Read the original here:

Counting down to a healthcare decision