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Health-care law: How Supreme Court ruling could affect US budget

US Supreme Court ruling on the health-care reform law's constitutionality will affect more than the making of public policy. It could also swing the federal budget significantly in either direction.

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Supporters and opponents of health care reform rally in front of the Supreme Court in Washington, March 27, as the court continued to hear arguments on the health care law signed by President Barack Obama.

Charles Dharapak/AP

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When the US Supreme Court hands down its ruling on the health-care reform law Thursday, the action will carry some big-money import for the federal budget.

A decision that strikes down President Obama's 2010 reforms in their entirety would increase federal deficits over the next 10 years.

By contrast, a narrow ruling striking down just one portion of the massive law could have a substantially different effect on government coffers. For example, a provision to expand access to Medicaid, if struck down, could save the federal government hundreds of billions of dollars, some finance experts say.

These facts aren't necessarily central to the question of what the Supreme Court should do, of course. The justices have been considering arguments pro and con that relate to weighty questions of constitutional law.

And from a public-policy viewpoint, the biggest issues at stake arguably are things separate from government finances: the health care Americans receive, its overall cost, and the way health-care policy affects the economy and job creation.

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