Earlier this week, a number of big health insurers, including two of the very largest—UnitedHealthcare and Humana—committed to offering some provisions of health reform. But those commitments would only apply to the 15 million or so consumers who buy their insurance directly from insurers or work for businesses that do so. Premiums for employer-based coverage have already gone up 8% to 9% annually in the past few years. And if the Supreme Court throws out the Affordable Care Act, there's a real risk that employees could see an "exponential jump" in premiums going forward, said Paul Keckley, executive director for Deloitte Center for Health Solutions.