The future of Health Care in the United States is more uncertain than at any other time in the past fifty years. This new uncertainty was created by the U.S.Supreme Court’s decision to receive a challenge to the Affordable Care Act (ACA), known by most as Obamacare. If you missed it, the oral arguments on the case were presented before the Court in an historic three days of hearings March 26-28. These were preceded by many briefs submitted to the Court from a broad spectrum of organizations. All of this information is available in the public domain. A detailed analysis of each day of the hearings may be found at healthaffairs.org.blog. A decision from the Court is expected in late June.

There is no certainty about how the Court will rule in the case before it. There are widely divergent speculations which are interesting to read, for sure. This is usual and customary. On the other hand, there is a difference this time. The entire healthcare system is likely to be impacted, many millions of citizens will feel it, and the political races from coast to coast are expected to react regardless of the outcome.

There is one certainty. The Justices of the Supreme Court have more power to influence the direction and content of how health care is provided and paid for than at any time in contemporary history with the possible exception of the era when Medicare and Medicaid were enacted in the mid 1960s. The Court’s decision will likely have substantial impact regardless of the decision. Here’s a summary of the major options under consideration.

The Court can conclude that comprehensive health care reform, as prescribed in the Act, is constitutional and should proceed. It would be a green light for substantial change for many.Or, the Court would post a red light and repeal the entire Act. That would return us to pre-2010 health care policy. Or, the Court could post a