FAQs about health care law ruling

The people most affected will probably be the ones currently paying for expensive, individual plans.  Their cost will go down and coverage will go up.

As for everyone else, it depends on their situation.

Here are a few scenarios, starting with the small business owner.

"We've been here for three and a half years.  We have about 25 employees," said Georgia Xanthoudakias.

The owners of Samaria Cafe don't have health insurance for themselves or their employees.

"Unfortunately, we can't afford it as a small mom-and-pop restaurant," she said.

The reform lowers policy costs to small business owners.

"It affords her the opportunity to buy in to a health insurance pool like a large company," explained USF Health's Jay Wolfson.

However, it doesn't require the employer to pay the bill.

"She could offer her employees the option of paying their own way at those much lower rates," Wolfson said.

Lisa Marotta can't afford health insurance, but she's trying.

"I'm in school to get a better job that offers insurance," she said.

With the reform she can join a big plan like Aetna or United.  The rate would be similar to what she'd get with that better job.

"So the law is trying to balance the playing field here and give more people access without being treated as if they were separate," Wolfson said.

However some don't want to pay for coverage at all, but now they'll be required.

"If I do make enough and still have to pay then that's more money our of your pocket.  If you live paycheck to paycheck that could set you back," said Dean Hadley.

The plan calls for a fine if you're caught without coverage, but it may not be policed unless you need treatment and can't pay the doctor's bill.

"I'm a school teacher and I feel like my insurance is pretty good," said Jim Dimillo.

So what happens if you have insurance through work and you like your plan and your doctor? It may stay the same, or your company could reduce benefits.  That's something many employers have already done to save money.

"They can force us in to a plan that we're not very happy about, but then we have the alternative of saying I'm going to quit my job and buy through the exchange," Wolfson said.

Some will be eligible without paying anything based on their income level.

Individuals paying more than $10,000 a year for insurance will now have the option to join a group plan, cutting their cost in half.

The reform affects everyone differently but it is expected to add millions of new insurance policies.

More from the Wall Street Journal:

Q: Does this mean the health overhaul law is in place for good?

A: The decision effectively upholds the law for now, but its future depends on which party controls the White House and Congress after elections in November. President Barack Obama and most Democrats consider the law a signature achievement and want to move forward implementing it. Republicans, including presumptive presidential nominee Mitt Romney, have pledged to overturn it. They say they would offer an alternative proposal but haven't been specific about what it would include.

Q: What happens to any benefits I already get because of the law?

A: They will stay in place for now. Parents will still be able to keep their children on their insurance plans up to age 26, and Medicare recipients will keep getting discounts on prescription drugs to close a gap in coverage known as the "doughnut hole." New levies under the law, such as the 10 percent tax on tanning services, also stay put.

Q: When will I see the big changes from the law?

A: Most of the mandates don't start until 2014. That is when most Americans will be required to carry insurance or pay the penalty at issue in the Supreme Court case. The penalty will start at $95 a year or up to one percent of a person's income, whichever is greater.

Tens of millions of Americans are expected to get insurance coverage under the system that starts in 2014. Some of the poorest Americans will become newly qualified to enroll in the federal-state Medicaid program—although the court appeared to make some changes to how that program will work. Another batch of people who earn more but still have low incomes will get tax credits to offset their insurance costs. Consumers will be able to comparison shop for policies in newly created exchanges that will operate like popular online travel websites.

Insurance companies will have to sell coverage to everyone, regardless of their medical history, and will have to restrict how much they vary premiums based on age. Companies with 50 workers or more will be required to offer insurance to their workers or pay a penalty.

Q: What if I already have insurance?

A: You may see changes to your plan. Unless your employer has "grandfathered" your insurance benefits' structure, your plan will have to meet new regulations under the law, such as covering more preventive services without out-of-pocket costs. There has been speculation that some employers will stop offering coverage and funnel workers toward exchanges once they open, but most companies say they have no immediate plans to do that.

Q: What will happen to my insurance premiums?

A: Most consumers can expect to keep seeing increases in premiums and co-payments because the underlying cost of health care is expected to rise. The law contains a few mechanisms to curb premiums, but it also requires that many insurance providers make their benefits more generous, which will raise their cost. Older people could see their premiums go down because of the new age rating rules insurers will face. People who buy policies without the help of an employer could get a better deal by being able to shop on the exchanges, where comparing plans will be easier than before.

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