Four scenarios for the health care law in 2012

Think about the Supreme Court is the only place to look to the future of health care reform?

You can read some polls first.

As re-election prospects of President Barack Obama fall, the chances of the law of health reform survival seem to fall, too.

So far, the Republican efforts to repeal or defund the Affordable Care Act were entirely symbolic, without control of the Senate or the White House, there is not much they can actually do.

But now, with the Democrats on the defensive in the Senate and Obama tanking poll numbers - 43 percent of respondents in a recent Politico / George Battleground poll Washington University said they will certainly not vote for his re-election - opponents of the law begin to think about strategies that the repeal could lead them to the finish line.

The fans are not panicking - but they are attentive."The outlook for the hinge Care Act affordable fully on the 2012 elections," said Ron Pollack, executive director of the health consumer group Families USA. "If Obama is elected - and I'm pretty confident that it will be, but it is for others to judge -. Then the Affordable Care Act will move, pure and simple"

It's a scenario. But there are at least four others - each of which has major implications for the future of the law on health reform and health care in America.

____

1.Obama loses, the Republicans take the Senate by a large number: the health reform is blown

This is the scenario with the most obvious result: If there is a Republican president and the Republican Party won a large majority in the Senate - say, 57 seats - the law of health care reform is probably history.

Would require 60 votes in the Senate to break a filibuster and pass legislation repealing the whole law - or at least the parts that were not yet in force. But even if the Republicans do not control that many votes, they could be close enough to pick up the votes needed to cross.

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Four scenarios for the health care law in 2012

It may well be able to get rid of the hated individual mandate — the requirement for nearly all Americans to get health insurance — unless the Supreme Court gets there first. Beyond that, though, it's not clear what could get through.



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Medicaid paid just 87.1 percent of hospital costs program patients incurred in 2005, according to America's Health Insurance Plans. Throw in unpaid bills from the 18 percent who are uninsured, and providers increasingly charge private insurers more to



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In the small-group health insurance market, the largest company had 30% of the market, according to an analysis done for the state last year. In the individual health insurance market, the largest company had 24% of the market.



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When Congress lacked the votes to put a "public option" in the law -- a government-run health insurance agency to sell insurance to the uninsured and compete with private insurers -- it substituted the "individual mandate." The first issue is legal:



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It provides health care coverage for children whose parents can't afford private health insurance or in this economy have lost their jobs. Medicaid provides access to preventive care needed to stay healthy. When our elderly can no longer live on their




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