That means the measure could be upheld if one conservative justice joins them and some saw evidence that Justice Anthony Kennedy could do so.
"Justice Kennedy asked very tough questions. And yet he described the unique dynamics of the healthcare market himself, more so than anyone else," said Ethan Rome, executive director of Health Care for America Now, a coalition of union and liberal groups that has been lobbying for reform since 2008.
"Not all healthcare advocates saw today as a good day. But that's the wrong way to read it," he said. "Kennedy needs to ask the toughest questions to assure conservatives that any non-ideological judgment will be based on the merits."
Ron Pollack, executive director of the healthcare consumer advocacy group Families USA, said the court's final ruling will depend on how many justices view the mandate as an instrument for regulating healthcare rather than spurring insurance sales.
"If it's healthcare, they'll come out in a way that understands healthcare consumes one out of every six dollars in the economy and that it's rational for Congress to regulate it," Pollack said.
Regardless of how the Supreme Court rules on the legal issues, healthcare reform's ultimate fate could lie in the political realm, depending on the outcome of November elections.
"If Senate Republicans become the majority next year, the first item on the agenda of the new Senate Republican majority would be the repeal of Obamacare (ACA) and the replacement of it with something that makes more sense and is targeted at the problems that we actually have in American healthcare," said Senate Republican leader Mitch McConnell.
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