Supreme Court's health care decision could affect millions

— -- For most Americans, the Supreme Court's ruling next week on President Obama's health care law will be largely an academic exercise with political fallout — but not yet personal implications.

For millions of people, however — some young, some old, some sick — the law already is affecting their pulse rates and pocketbooks, and a decision to strike it down could come with a medical or financial cost.

Among the decisions the justices might render, such as upholding the law or striking down the mandate that most Americans get health insurance, tossing out the entire law could have the greatest impact.

That's because the law's Democratic authors purposely ensured that many popular provisions, such as covering young adults, would kick in first. Most of the $500 billion in new taxes and fees, reductions in Medicare payments to hospitals and other health care providers and mandates that individuals get health insurance become effective in 2013 and 2014.

Some insurers have said they would retain popular provisions such as keeping young adults on their parents' policies, but a court ruling that strikes down the law would eliminate both its legal basis and its funding. Though few expect the ruling to be applied retroactively, little will be guaranteed looking ahead.

"I'm just devastated that they could throw that out," says Judy Lamb, a cancer patient in Golden, Colo. "There are just so many people that need it — people like me."

Lamb, 59, has benefited from the law's ban on lifetime limits in health insurance policies. After battling breast cancer that spread to her bones and liver, she was close to hitting the $2 million limit on her husband's employer-provided plan.

Two of her children, 25 and 23, have taken advantage of the law's provision that enables young adults to stay on their parents' policies until they turn 26.

That's a crucial provision for Terrance Black, 23, an unemployed Cincinnati resident with diabetes who was without insurance until the law allowed him to get back on his mother's policy.

Black's medical expenses for insulin, syringes and testing strips were high, forcing him to accumulate debt for what his mother, a bus company clerk, couldn't pay.

"I was working overtime like crazy just to be able to afford his medicine," Marian Black says. If the law gets thrown out, she says, "I would be paying for all the medicine again."

Another beneficiary is Steven Giallourakis, who will turn 22 next month. He has been in and out of college while dealing with leukemia. At 19, he was forced to return to school soon after a bone marrow transplant, just to get health coverage.

Like Lamb, Giallourakis came close to his $2 million lifetime limit. The Cleveland resident hopes to complete college and choose a job based on interest, not insurance.

"I'm praying that it doesn't get thrown out," he says. The government has "an obligation to take care of the people who are ill and the young people who are going to be the future of the country."

Consumers, businesses face loss

In Chicago, Dan Morgridge has been helped by a provision of the law that created a temporary high-risk insurance pool for people who had pre-existing conditions for at least six months.

Morgridge, 28, spent years uninsured until severely injuring his knee, which required physical therapy. Fearing expensive surgery, he joined the law's temporary high-risk insurance pool.