After the Supreme Court decision: what's next for reform

A Republican sweep in the November elections could lead to repeal of most of the Affordable Care Act, to be replaced with legislation to achieve limited coverage expansion. A Romney victory and split Congress would likely result in Republicans using their administrative authority to modify or disrupt implementation of the act, with provisions altered or repealed where bipartisan agreement exists. An Obama victory and split Congress would likely result in continued implementation of the act but with a delay to some elements.