Each potential scenario, however, presents a different set of issues and choices down the line:
If only part of the law is struck down
As the nation awaits a decision from the Supreme Court on the constitutionality of President Obama's flagship health care law, Yale University Law Professor Akhil Amar joined the "CBS This Morning: Saturday" co-hosts to examine the issues the justices are considering.
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This is, in many ways, the most complicated scenario: The court upholds all of the law except a mandate requiring individuals who do not receive coverage from their employers or the government to buy it from private insurance companies, or pay a fine.
“If the court throws out the mandate and leaves the rest of the law in place, the big question is going to be, does Congress try to go forward with the rest of the law without the mandate?” said former Mississippi governor Haley Barbour, a Republican whose state joined the legal challenge to the law’s constitutionality.
The Obama Justice Department argued before the Supreme Court that if the individual mandate is struck down, other parts of the law should be as well. Those include a requirement that insurance companies cover those with preexisting conditions and a ban on practices that allow health insurers to vary their premiums based on age, gender, health status or other factors.
But forcing insurers and hospitals to cover and treat sick people, without guaranteeing them a pool of less expensive health people to cover the cost, would drive up their prices.
“It does make insurance more expensive, and encourage adverse selection,” in which people wait until they are sick to find coverage, Wilensky said.
And if the costs of insurance soars, even fewer people will buy it — setting off what the insurance industry calls a “death spiral.”
America’s Health Insurance Plans, the insurance industry’s lobbying group, has commissioned studies to show what happened during the 1990s in two states where insurers were required to provide coverage but people were not required to buy it.
In Kentucky, dozens of insurers fled the state, leaving only a handful doing business there; premiums in some cases more than doubled.
In Washington state, the number of people uninsured actually rose by nearly 30 percent, because fewer could afford it from the two insurers who were left in 1999.
Healthcare experts say these experiences suggest what could happen nationally.
But forcing insurers to cover those with preexisting conditions and forbidding discrimination by age and gender are two of the most popular elements of the federal law. That means that politicians may well be under intense political pressure to restore them.
Some states, following Massachusetts’s lead, might themselves impose individual mandates.
Other options include charging a penalty to people who are eligible for coverage but who wait. Medicare has such a system for those who turn 65 but do not immediately avail themselves of its voluntary portions, covering doctor visits and prescription drugs.
If the law is struck down
More optimistic Democrats say this could actually energize their base.
“Right now, the greatest intensity is on the side of people who don’t like the Affordable Care Act,” said William A. Galston, a senior fellow at the Brookings Institution and a former top policy adviser to President Bill Clinton. “But my experience is that a bitter loss mobilizes people.”
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