obamacare

The Affordable Care Act requires all Americans to get health insurance or pay a penalty. To help coax people to buy a health plan, the federal government now subsidizes premiums for millions of Americans.

This time last year, federal officials were scrambling to get as many people enrolled in health insurance through HealthCare.gov as they could before the start of the program on Jan. 1.

Now, with the technical problems mostly fixed, they're facing a different problem: the possibility that the Supreme Court might rule that the subsidies that help people afford coverage are illegal in the 37 states where the federal government is running the program.

On a recent afternoon at his office in Hartford, Conn., Dr. Doug Gerard examines a patient complaining of joint pain. He checks her out, asks her a few questions about her symptoms and then orders a few tests before sending her on her way.

For a typical quick visit like this, Gerard could get reimbursed $100 or more from a private insurer. For the same visit, Medicare pays less — about $80. And now, with the new private plans under the Affordable Care Act, Gerard says he would get something in between, but closer to the lower Medicare rates.