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After Years Of Uncertainty, A Health-Care Business Gets An Answer

It's 9:45 a.m. Thursday at the headquarters of Health Plan One, a health insurance agency that sells private policies. It's the morning of what is the biggest court decision ever regarding health insurance. Will the court uphold the health-care bill? Will it strike it down?

"Either way is fine with me," says Bill Stapleton, the company's CEO.

Stapleton is a man who is worn out. He spent years watching Congress debate the health care overhaul, gaming out how his company could survive under this version or that version. And then the law was passed and then the constitutionality challenged.

"It's very difficult to plan because there's so much uncertainty out there," Stapleton says. "That doesn't sound like a big deal. It's a big deal. How do you make an investment today? Your investment doesn't pay off today. It pays off in three or four years."

It's 10 a.m. Someone gets the TV working, and there's Wolf Blitzer on CNN announcing that the court has struck down the insurance mandate. Then Stapleton walks over to one of his salesmen, who tells him Yahoo is saying the bill has been upheld.

This kind of confusion, Stapleton says, is actually typical of how the past few years have been.

Eventually, the news is clear: The law was upheld. And unless Stapleton's company dramatically changes what it does, it has just been written out of existence. And not by the controversial parts of the law, but by the parts of the law most everyone likes.

For instance: Insurance companies have to reduce administrative costs. Stapleton's agency collects fees from insurance companies. His business is an administrative cost.

And starting in 2014, the law says insurance companies will not be allowed to deny people for pre-existing conditions. And at some point, people won't need to go through an agency like Stapleton's at all; the law creates online exchanges to buy insurance.

Stapleton says he's thinking about getting into life insurance. Or maybe car insurance or home insurance — anything that moves him away from the individual health market.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Chana Joffe-Walt