In Washington, the health care reform battle rages on — and the MLR requirement remains one of the legislation’s most provocative points. In August, a three-judge panel from the Supreme Court’s 11th Circuit Court decided in favor of the 26 states that demanded a repeal of PPACA’s individual mandate. The ruling declared the mandate’s requirement that all Americans purchase government-approved health insurance to be unconstitutional, but allowed the rest of the law to remain intact.

The 26 states that originally filed suit appealed this ruling, arguing that the mandate was critical to the Act and, once removed, would render it unworkable. In the face of their new demand to repeal the whole package, the Obama administration has also appealed, stating that all aspects of the 2,700-page legislation are Constitutional.

How will the Court respond? Here are six possible ways.

  1. It could reverse the lower court’s ruling, determining that Congress has the power to pass the individual mandate as part of the law.
  2. It could decide to keep the law intact, mandate and all, ruling that this demand is not really a mandate to buy insurance, but a new tax on the uninsured.
  3. It could uphold the lower court’s ruling, establishing the individual mandate as unconstitutional, but keeping the rest of the law intact.
  4. It could declare the mandate unconstitutional, along with the law’s “guaranteed issue” and “community rating” provisions, while upholding the rest of the law.
  5. It could declare the entire law unconstitutional, as the committee of states has requested.
  6. It could determine that the states lack legal standing to appeal this suit at this time, postponing all decisions until after the election year and, most likely, until after its implementation in January 2014.

Read the story.