How far will the ruling reach?

What the Supreme Court decides will impact the billions of dollars that have already been spent to implement the measure, as well as consumers, employers, small businesses, the health care industry, the insurance marketplace, and, of course, politics and K Street.

The Wall Street Journal's Washington Wire: Four Scenarios For Thursday's Ruling On Health Care
The Supreme Court's eagerly awaited ruling on the 2010 federal health-care law is expected on Thursday, when the court will announce its final opinions of the term. … On the health care law, here are the most likely four scenarios on how the court could rule, as first laid out by Law Blog last week, shown in order of how much of the law would be struck down (Kendall and Landers, 6/25).

The Wall Street Journal: Health-Law Money In Limbo
Now that the Supreme Court has announced it will rule Thursday on President Barack Obama's 2010 health-care overhaul, one of the biggest questions that hangs over the decision is what happens to the billions of dollars already spent or pledged to carry out the law if parts or all of it are struck down (Radnofsky, 6/25).

The Washington Post: What Small Business Owners Should Know About Each Possible Supreme Court Health-Care Ruling
The Supreme Court is set to release its ruling on the constitutionality of President Obama's controversial health reform law, the Affordable Care Act (ACA), as early as this week. In addition to the highly divisive individual insurance mandate, the ACA contains a variety of provisions designed to broaden access to health insurance coverage, end perceived unfair insurance practices, bend the cost curve and modernize payment methods. Some of these changes have already kicked in (Maruca, 6/25).

National Journal: More Than 22 Million Could Lose Insurance With Supreme Court Decision
More than 22 million people who would have gotten cheaper health insurance or coverage from Medicaid will be out of luck if the Supreme Court overturns the entire health care law, according to analysis from consulting firm Avalere Health. Most of those who would lose out live in big states. The report found 55 percent live in 10 states: California, Texas, Florida, Illinois, North Carolina, Ohio, Georgia, Michigan, New York, and Pennsylvania. "If the Supreme Court rules that the Affordable Care Act (ACA) is unconstitutional, approximately 22.4 million individuals who would have obtained Medicaid or subsidized exchange coverage by 2015 will remain uninsured," the report reads (McCarthy, 6/25).

The Hill: Swing States Would See Biggest Losses In Coverage If Court Strikes Health Law
Several key swing states would be hit especially hard if the Supreme Court strikes down President Obama's healthcare reform law, according to new data from Avalere Health. If the court throws out the entire law, about 22.4 million people who would have gotten access to insurance coverage will remain uninsured, Avalere said. About 15 million people who would have been eligible for Medicaid would instead remain uninsured, as would roughly 7.5 million people who would have gotten subsidies to help pay for private insurance (Baker, 6/25).

Chicago Sun-Times: Supreme Court Health Ruling Has Potential To Help, Hurt Insurers
The Supreme Court ruling Thursday on the Obama administration's health care law could open the doorway for millions of new customers for Blue Cross and Blue Shield of Illinois and other insurers, or lead them to back out of the individual insurance market, industry analysts say. … Insurers, including Blue Cross and Blue Shield of Illinois, the largest health insurer in Illinois with nearly 7 million members, would benefit from the new insurance marketplaces or exchanges that states would have to set up for individuals shopping for insurance, said Morningstar Inc. health care analyst Matthew Coffina (Knowles, 6/25).

Chicago Sun-Times: Hospital Stocks Will Face Test With High Court Ruling
Analysts for health care stocks said that if the Supreme Court upholds any part of the law, the value of shares in the industry is likely to rise. But after that first-blush reaction, the stocks could decline as the industry grapples with new uncertainty, the analysts said. If the mandate is struck down but higher taxes on health care companies remain, the incentive for increased business volume would be gone. The change could hurt the earnings of hospital chains such as Universal Health Services or Tenet Healthcare (Roeder, 6/25).

CQ HealthBeat: NAIC Considers Exchange Issues On Eve Of Court Decision
The National Association of Insurance Commissioners is set to meet in Washington for two days this week and plow ahead on the policy work of implementing the health care law just before the Supreme Court is expected to issue a decision on the overhaul's constitutionality. Members of the Health Insurance and Managed Care (B) Committee will meet Tuesday and Wednesday to discuss white papers dealing with such issues as the operation of health plan networks within state health benefits exchanges -; amid some comments from consumer representatives suggesting regulators need to do much more to ensure the public understands network choices and restrictions (Norman, 6/25).

The Hill: Feds: Health Care Law Saved Seniors Billions On Prescription Drugs
Federal officials touted billions in savings for seniors under healthcare reform just hours before the Supreme Court might have ruled against the law. According to the Medicare agency, more than 5 million seniors and people with disabilities have saved about $3.7 billion on prescription drugs since the Affordable Care Act was enacted. "Thanks to the health care law, millions of people with Medicare have been paying less for prescription drugs," said Marilyn Tavenner, acting administrator of the Centers for Medicare and Medicaid Services (CMS) (Viebeck, 6/25).

Roll Call: K Street Files: Lobbyists Prep For SCOTUS Ruling
On K Street, waiting for the Supreme Court's health care ruling goes something like this: schedule post-decision client conference calls, write multiple drafts of talking points for different outcomes, and hole up in a conference room trying to figure out whether constitutional law-speak can translate into English. Every interest with a stake in the health care overhaul -; which covers basically every lobbyist in town -; has been waiting and speculating on whether the statute survives a constitutional challenge. And they are waiting some more with the decision not due until Thursday…A spokesman for one of the most closely watched parties, America's Health Insurance Plans, declined to comment on internal strategy, meetings or whether it's set up a SCOTUS war room. But spokesman Robert Zirkelbach did say the health care plan lobby plans to trumpet how a requirement in the law that would make insurers cover everyone, including those with pre-existing conditions, is inextricably linked with other insurance reforms (Ackley, 6/26).