CHARLESTON, W.Va. -- A key feature in the Affordable Care Act, is the coverage of virtually all Americans by some type of health plan. There will be substantial expansion of Medicaid to cover low-wage workers and their families and a state health insurance exchange that offers health plans and subsidies to individuals and small businesses.

Once these supports are in place, it will be each person's responsibility to enroll -- through an employer, a government program, or the health insurance exchange. This provision is referred to as the "individual mandate."

Based on the questioning raised during oral arguments on the Affordable Care Act before the U.S. Supreme Court, some observers believe that the court will find the individual mandate unconstitutional; that Congress cannot require Americans to have health insurance coverage or pay a penalty.

What happens next if the court holds the individual mandate to be unconstitutional?

Laws frequently have a severability clause that says if any part of the law is held unconstitutional, all other parts of the laws are to be held constitutional. Where there is no severability clause, as is the case with the ACA, previous courts have ruled that the court should determine if other sections of the law can stand on their own merit. Those provisions that are so intertwined with the unconstitutional provision that they cannot stand on their own are also stricken. However, if other provisions can stand on their own, then the court should not overrule the decision made by Congress and the president.

If the Supreme Court follows precedent, then there are probably only two other sections at risk of being stricken, if the individual mandate is found to be unconstitutional.

The first is prohibiting insurance companies from denying a person a policy because they have a pre-existing condition.

The second provision at risk limits what insurance companies can consider when establishing a monthly premium. Under the ACA, insurance companies can only consider a person's age, family size, whether they use tobacco, where they live, and if they participate in an employer-sponsored wellness program when setting a consumer's premium. This provision prohibits insurance companies from considering a person's health status or gender in setting premiums. If this clause is removed from the ACA, then insurance companies will be able to continue to charge sick people a higher premium and continue the practice of charging women a higher premium than men for the exact same policy, what is called gender rating.

These reform measures are at the heart of the insurance reforms in the Affordable Care Act. Losing these two provisions and allowing insurance companies to discriminate against people with pre-existing conditions and women are significant setbacks. Make no mistake about that.

However, the ACA is a lot more than insurance reforms. There are numerous very important provisions that don't have anything to do with the individual mandate, and should be upheld by the Court. For example:

* Expanding Medicaid to 120,000 low-income West Virginians and 16 million Americans has nothing to do with the individual mandate and should not be touched by the court.

* Providing tax credits in the Health Insurance Exchange in order to make premiums more affordable for moderate-income individuals and small businesses is not so intertwined with the individual mandate that it cannot stand on its own. Clearly, exchanges do not work as well without the mandate. Without the mandate, exchanges will suffer from what is called "adverse selection." Younger, healthier people decide not to purchase coverage leaving the exchanges with older and sicker people. Without the individual mandate, premiums will be higher and fewer people will be in the exchange. But the exchanges can still function.

* Changing our health care delivery system to put more emphasis on prevention has nothing to do with the individual responsibility provisions, and should be upheld by the Supreme Court even if they strike down the individual responsibility provisions.

* Closing the "doughnut hole" in Medicare prescription drug coverage is not contingent on the individual responsibly provisions of the ACA. Nor is allowing young adults to stay on their parents' insurance policy until their 26th birthday. Both should survive the Court's ruling.

* Doubling the appropriations for community health centers and the Nation Health Services Corps so that the nation can increase the supply of primary care providers are not related to the individual mandate, and should be left intact by the court.

There are too many provisions to list here that are unrelated to the individual mandate provision and should be beyond the court's reach. The important point is that the loss of the most important changes in how the insurance industry operates is significant, but these reforms should not be considered the totality of the ACA. If the Supreme Court follows tradition and defers to the legislative branch, numerous highly beneficial provisions of the ACA will remain even if the individual mandate is voided.

It remains to be seen if this court will follow what Justice Felix Frankfurter called "judicial self-restraint" or continue their activist approach that is embodied in their decisions of Citizens United and Gore v Bush. Health care coverage for millions of Americans hangs in the balance in which approach the court takes.

Bryant is executive director of West Virginians for Affordable Health Care.