The United States Supreme Court is scheduled to announce its decision this week on the constitutionality of the healthcare reform plan passed by Congress in 2010. The Court won't have the final word, however. If it upholds the law, Republicans are committed to repealing "Obamacare" if they are swept to power in November. If all or parts of the law are struck down, the Democrats can be relied upon to try to work around the ruling. Such is the way of American governance.
The stakes are huge, not only politically but financially, as well. A welter of issues interact in any attempt to reform the nation's healthcare delivery system, and among those is how the elderly and disabled will live. There is a nationwide movement underway to de-emphasize the role of nursing homes and aid those who wish to live in a private home, group home, etc. How that effort will fit into the overall structure is not yet clear. If supporting people in less institutional settings turns out to be revenue neutral, the idea might be decided on its merits. If, however, that approach is seen as being more expensive for the government, proponents of the approach might have to be particularly persuasive.
A lot is riding on the Supreme Court decision later this week, on the results of Election Day, and on what Congress and state legislatures do over the next few years.
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