In the play Waiting for Godot, Godot never arrives, but the entire play is consumed with hand-wringing about what might happen if he did appear. In the case of the Affordable Care Act, there is similar hand-wringing over the Supreme Court decision about the fate of health reform, although we know the answer will arrive by the end of June. What are the possibilities for a Court decision on health reform and what might the impact be in each case? If the entire Act is declared unconstitutional, Americans could lose a number of benefits that have already been implemented; or, we could lose the opportunity, once health reform is fully implemented in 2014, to choose a health plan through a state exchange. With that loss, we would see a revival of the high cost of individual insurance plans and the chance of being rejected for coverage.