by Ken Alltucker - Jun. 26, 2012 11:25 PM The Republic | azcentral.com

The U.S. Supreme Court's highly anticipated ruling on the nation's health-care law is expected Thursday, and the justices' decision will have a profound impact on the way Americans get health care.

The nation's high court could keep intact all -- or just part -- of the Affordable Care Act passed by Congress in 2010. Or the court may strike down the entire law.

Even if the Supreme Court tosses out the act, thorny issues remain, including access to care for the estimated 50 million Americans without health insurance, spiraling health costs, affordability, quality, and waste and abuse in the system.

Here are some possible outcomes of the Supreme Court's ruling:

Question: What happens if the law is upheld in its entirety?

Answer: Arizona consumers would keep early benefits of the law, such as some preventive health care covered at 100 percent and rebates from insurance companies that did not spend at least 80 percent of premiums on medical care or quality.

But the big changes won't come until 2014, when most Arizonans would be required to obtain health insurance. Now, about 1 out of every 5 Arizonans does not have health insurance. Most of these uninsured people would get health insurance through expanded Medicaid coverage or through a health-insurance exchange that matches consumers and insurance companies.

Hospitals, doctors, health insurers and employers have made significant changes to prepare for the law. Arizona hospitals, for example, have started new programs that emphasize a coordinated and team approach to health care. Some health providers will be paid based on how well they keep people healthy, not the traditional fee-for-service model that pays doctors or hospitals based on tests and procedures.

While consumers, employers and the health-care industry have adjusted to the law, the political battle is unlikely to end anytime soon.

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Bracing for big health-care law ruling