Policy expert looks at consequences of health care ruling - Atlanta News, Weather, Traffic, and Sports | FOX 5

The Supreme Court is expected to issue the most important health care ruling in United States history on Thursday. The decision will decide the fate of President Obama's sweeping, but controversial health care reforms.

The court could strike down all, or parts of the Patient Protection and Affordable Care Act. They may also leave it intact.

Many Georgians don't like the federal government telling them they have to get health insurance.  At the same time, they do like some of the potential benefits of this law: tax breaks for low income families, coverage for people with health problems, and programs to help individuals negotiate better insurance deals.

Georgia State University health policy expert Pat Ketshe says a lot of Georgians, insured and uninsured, are trying to figure out what it means for them.

"Will I be able to buy insurance?  Will I be able to afford insurance, will my employer continue to offer insurance?" said Ketshe.

At issue is whether the act is constitutional, or a government overreach to require Americans to purchase health insurance or face a tax penalty. It's called the individual mandate. What if the court strikes it down?

"Then the fear is people won't buy health insurance until they need it. They will just not bother.  They know they can get it when they need it," said Ketshe.

Why is that a problem? The health insurance industry is counting on this law to convince millions of young, healthy Americans to get coverage.
    
That would help offset the cost of a new requirement insurers offer coverage to people with chronic illnesses, without charging them more.

If the Court strikes down the requirement for coverage, but keeps the protection for people with pre-existing health problems, that could drive premiums up as high as 30 percent, sending the insurance industry into what some call a "death spiral."

"Because healthy people stay out. Sick people buy the insurance, the premiums go up.  And every time the premiums go up, more healthy people opt out of plans," said Ketshe.

Also at stake is a major Medicaid expansion that could offer coverage to 600,000 lower income Georgians. Insurance exchanges should be up and running in about two years. They would let individuals and small businesses to pool together, and negotiate better rates with insurance providers.