My guess is it will limit the number of vendors, force standardization, and move the center of the industry decisively to Washington, D.C.
Right now the industry is scattered. Most vendors are based in Silicon Valley, Many payment processors are in Atlanta. Others are dispersed around the country, near universities, major customers, and where the founders live.
Reform would force every vendor which wanted to stay viable to have a major presence in Washington. If states are given a major role, each state you wanted to be in would need an office.
The focus of competition would also change. Right now it's all about innovation, about speeds and feeds, and about proprietary advantage. Reform would change the key drivers to price, interoperability, and lobbying prowess.
These are just guesses, of course. Right now real health care reform seems more distant than Mars. Thus the picture I've chosen above, which comes from NASA. But change does happen.
If it does, will you be ready?