MANCHESTER — What will happen to your insurance coverage once a decision is handed down today from the U.S. Supreme Court on the Patient Protection and Affordable Care Act?

That not only depends on the ruling, but on who insures you and your family.

Cigna and Anthem won't comment until after the ruling. Harvard Pilgrim Health Care and UnitedHealthcare have committed to continuing certain popular provisions of the act, regardless of which way the court rules.

Harvard Pilgrim Health Care, in a statement from President and CEO Eric Schultz, said it would keep at least three key provisions of the Affordable Care Act. They are:

-- Coverage of federally defined preventive care services with no cost sharing, including coverage for women's preventive care beginning Aug. 1, 2012.

-- Coverage of dependents until age 26.

-- Removal of annual and lifetime limits pertaining to essential health benefits.

► The Supreme Court's ruling on the Affordable Care Act is expected some time after 10 a.m. Click here for immediate updates from www.scotusblog.com. Twitter: @SCOTUSblog.

UnitedHealthcare said it will continue provisions related to coverage of preventive health care services, coverage of dependents up to age 26, lifetime policy limits, rescissions and appeals.

MVP Health Care President and CEO David W. Oliker said, “In general, if there is a mixed decision, some parts of the law are upheld and some are invalidated. There will be fewer changes in New Hampshire than in many parts of the country, as New Hampshire already has many of the reforms enacted by the ACA, including community rating and an external review process.

“If the entire law is invalidated, MVP will continue to offer coverage consistent with the ACA consumer protection provisions that are in state law, such as guaranteed issue regardless of health or risk status for the small group market, coverage of dependents to age 26 and allowing women to select an OB/GYN as her primary care provider or parents to select a pediatrician as their child's primary care provider,” he said.

Not of one mind

N.H. Insurance Department lawyer Jennifer J. Patterson said, “To me, what's really going to matter is what the court itself says. The first thing we'll do is read the court decision and see what it means.”

Insurers aren't of one mind in confronting the issues involved in the ruling, according to Stephen A. Norton, executive director of the N.H. Center for Public Policy Studies.

“The insurance companies provided moderate support to the reform efforts because of the mandate which would provide premium dollars,” Norton said.

“If the Supreme Court says they are going to repeal the mandate, it complicates the question of health insurance premiums tremendously because there are things like guaranteed issue that could result in people only enrolling when they are sick and that's not what the insurance companies want,” Norton said.

Other concerns

Northeast Delta Dental President and CEO Tom Raffio said children's dental coverage is one of 10 essential benefits that all health plans must include under the ACA.

One potential conflict if that portion of the law is upheld, Raffio said, is that the Affordable Care Act bars caps on coverage but nearly all dental plans have a cap on coverage.

“Even the richest dental plan out there has maximums, so that's the one concern we have,” he said.

MVP President Oliker said, “One provision of the health care reform law that MVP does think should be changed is that the 'Small-Business Health Insurance Tax' (HIT) should be repealed. The ACA established several new taxes, including taxes on health insurers, pharmaceutical manufacturers and medical device manufactures that will raise the cost of health care and health coverage for individuals, families and employers.

“New taxes will increase premiums by approximately 5 percent more than current cost trends in 2014 and will similarly increase costs in subsequent years,” Oliker said.

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Denis Paiste may be reached at dpaiste@unionleader.com.