First let's look at Medicare. The ACA changed the formulas that Medicare uses to pay providers and it will be increasing reimbursement for primary care. It baked in financial incentives for doctors and hospitals that achieve quality benchmarks. The Centers for Medicare and Medicaid pays out 100 million medical bills each month according to the new pay scale. What will happen if the law is overturned? Will it go back to 2009 pay? Will pay be frozen until the House Ways and Means and Senate Finance Committees can meet and decide? No-one knows.
The Health care law also dedicated billions of dollars to expand community health centers and the health care workforce including the Indian Health Service. If it disappears the legal authority for those programs and funding would also disappear.
Lets look at the Centers for Disease Control and Prevention (CDC). The law's Public Health and Prevention Fund would lose $10 billion dollars for community health ventures like lead-poisoning prevention and immunization programs. There are no contingency plans for this funding.
More than 22 million people who would have gotten cheaper health insurance or coverage from Medicare will be out of luck if the law is overturned. "More than 5.2 million Medicare beneficiaries have saved a total of $3.7 billion on their prescription drugs since the health care reform law went into effect", according to CMS Acting Administrator Marilyn Tavenner. If the law is overturned, the "donut-hole" will remain open.
Without the federal law, insurers can still deny coverage to people because of their medical conditions and they can exclude pre-existing conditions from coverage. Take that, Americans, if you have diabetes or arthritis or prior cured cancer. If you are a young adult covered on your parents policy you might lose that coverage. In California that has become State law but most States do not cover it.
Studies show that most Republicans want the law nullified and have even turned it into a religious issue which absolutely baffles me. Anti Obamacare spending has outspent supporters 3:1. But even for people in the health industry the law is confusing and way too complex with provisions that kick in slowly over time. That has confused everyone.
One thing that is guaranteed. The Supreme Court ruling will make half of American happy and half of America unhappy. Attorneys will be employed for the next decade with appeals and further confusion. The Insurance Industry and Pharmaceutical Industry will do just fine in any case because health care will continue to be a growth industry.