One of the key provisions of the Affordable Care Act that went into effect last year was that insurers were required to spend at least 80 percent of the premium dollars they received on actually paying for health care delivery—not administrative costs or profits. If insurers didn't meet that threshold, they would have to pay out rebates to their customers to cover the difference. That would mean more than $1 billion in rebate checks sent in the next few months.

Except for one wrinkle.



If the Supreme Court overturns the health-care law — a decision that could come as early as Thursday morning — experts say those checks are unlikely to hit Americans’ mailboxes. “If [the Supreme Court] says the law is unconstitutional, insurers couldn’t be forced to pay rebates based on unconstitutional laws,” said Tim Jost, a law professor at Washington and Lee University.

A new report from the administration says that nearly 13 million Americans would be getting the rebates, at an average of about $151 per household. Which might not be arriving in 12.8 million mailboxes in the next few weeks, because the Supreme Court will probably take it away.

If there's any silver lining to this, it's that for one year, insurance companies generally did meet the demands of the law. Before the provision was enacted, health care system experts expected that rebates owed would be over $2 billion. Which means the law did what it was supposed to: make insurers spend more on covering actual health care.