A mounting U.S. deficit could pose a much greater threat to the survival of President Barack Obama’s health-care overhauls than either the U.S. Supreme Court or 2012 elections, Reuters said.

Many health experts say innovations in delivering medical care and the creation of state health insurance exchanges for extending coverage to the uninsured are likely to continue in some form even if Obama’s 2010 Patient Protection and Affordable Care Act is struck down or repealed.

But former top health-care policy-makers from Democratic and Republican administrations warn that some of the most promising measures for controlling costs, while improving quality and access to care, could run aground as early as 2013 if a new Congress and administration respond to the fiscal pressures with arbitrary spending cuts.

“If the plan is what’s on the table now, which is cut, cut, cut — shift the burden to poor people and taxpayers, take away benefits, take away Medicaid coverage — things will get worse,” said Dr. Don Berwick, who left his temporary post as Obama’s head of Medicare and Medicaid this month after Republicans blocked his Senate confirmation.

The Affordable Care Act is designed mainly to extend health-care coverage to more than 30 million uninsured Americans by expanding Medicaid for the poor and establishing state exchanges where people with low incomes who do not qualify for Medicaid can buy subsidized private insurance.

It also calls for innovations that could guide America’s $2.6 trillion health-care system, the world’s most expensive, toward incentives to contain costs.

The Supreme Court is expected to rule next spring on the constitutionality of the individual mandate, the law’s provision that requires all Americans to buy insurance.