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It’s nail-biting time on the Affordable Care Act

The long wait for a Supreme Court ruling in Florida's lawsuit against the Affordable Care Act will end soon --- probably on Thursday. As some have said, the suspense is reminiscent of waiting for the verdict in the O.J. Simpson trial in1995.

If Florida prevails and the entire law is thrown out, there will be jubilation for some, angst for others.

Leading the celebration will be Gov. Rick Scott, who is already preparing his remarks, and Attorney General Pam Bondi, who has leveraged her role in the case to attain a national audience among conservative activists. Others who have opposed the Act on political or ideological grounds also would be happy.

Another big winner could be the Pentagon, which could get much of the money that would have been spent on covering the uninsured.

Hospitals and other corporate interests that stand to gain 35 million new paying customers have a lot to lose if the Act is declared unconstitutional. Worst-case for insurers would be a split decision that requires them to continue to enroll all comers but throws out the “mandate” that requires everyone to participate.

Of course, the individuals who would be most affected if the Act were thrown out entirely would be the largely voiceless uninsured – including 3.5 million Floridians – who could qualify for help in buying coverage under the Act. Many of them are not even aware of what is in the law.

In a reminder of why the nation has gone through all this angst, The Tampa Bay Times on Sunday offered short profiles and videos of several people who desperately need the coverage.

Others who would lose benefits only recently gained include:

--Medicare beneficiaries who have high drug bills and have received help for the “doughnut hole” in Medicare's prescription drug coverage, Part D. Last year, 3.6 million beneficiaries received discounts worth $2.1 billion.

--Working-age Floridians who don't have coverage through their employer and who have a health problem, such as high blood pressure, that keeps them from qualifying for a decent plan. Private insurers were forced to accept children with pre-existing conditions soon after passage of the Act in 2010, and adults would gain similar protections in 2014.

--Small employers and individuals who have had to buy exorbitant plans that spend relatively little on their health care and who now qualify for rebates under the Act beginning later this summer.

--Young adults up to age 26 who were able to stay or get on their parents' policies. While some companies said they would not drop them, the tax situation might make it necessary, as NPR reported last week.

Many observers think the most likely outcome is that the Court will throw out the mandate, either by itself or with the rest of "Title 1" of the Act, which covers the new rules for insurers. Some policy analysts think the mandate is so weak that it won't matter much if it disappears. But if the requirement that all be covered goes away, that will leave the nation in the same place it started: with 50 million uninsured.

Today the Court issued long-awaited rulings on several other looming issues. It struck down provisions of Arizona’s immigration law and affirmed the much-criticized Citizens United ruling by striking down a Montana law limiting corporate campaign spending.

The court also ruled that it is unconstitutional to sentence juveniles to life in prison without parole for murder.

--Health News Florida is an independent online publication dedicated to journalism in the public interest. Contact Editor Carol Gentry at 727-410-3266 or by e-mail.