By Mary E. OLeary, Topics Editor moleary@nhregister.com / Twitter: @nhrmoleary

There is a lot at stake.

Connecticut officials, like the rest of the country, are anxiously awaiting the Supreme Courts decision on health care reform, which could be announced as early as Monday.

It is generally conceded that the Obama administration has lost the public relations war over the Patient Protection and Affordable Care Act, and the reforms will remain controversial no matter what is upheld or struck down by the high court as the country heads to a presidential election in November.

Much of the discussion has centered on whether the individual mandate to buy insurance is constitutional, but changes to the wide-ranging market reforms that are rolling out, the establishment of insurance exchanges and a vote against increasing the Medicaid population could prove to be more problematic for the states.

It is estimated the Affordable Care Act would add coverage for some 30 million uninsured Americans, a total of 17 million through expanding Medicaid.

In Connecticut, estimates by the Rand Corporation are that 130,000 additional people would be on Medicaid, with 100 percent of the cost of the new enrollees picked up by the federal government for three years from 2014-16, slowly declining to 90 percent by 2020.

Rand estimated 10 percent of Connecticuts nonelderly population, or 310,000, will participate in the insurance exchange now being worked on, while the number of uninsured by 2016 will be about half of what it would be, or 170,000, rather than 340,000, if the ACA wasnt in effect.

Its hard to find a person who will not be touched by this decision, said Vicki Veltri, Connecticuts health care advocate. Everyone with coverage and those who need coverage will be affected in some way.

The court will look at the division of power between the states and the federal government and the ability of Congress to regulate commerce. It will decide if sections of the law can stand alone and whether this is the right time to rule on the constitutionality of the ACA or if it has to wait until 2014 tax returns are filed in 2015.

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