The future of health care in America is on the table.

After more than an hour of arguments Wednesday, the Supreme Court seemed divided in a case concerning what Congress meant in one very specific four-word clause of the Affordable Care Act with respect to who is eligible for subsidies provided by the federal government to help people buy health insurance. If the Court ultimately rules against the Obama administration, more than 5 million individuals will no longer be eligible for the subsidies, shaking up the insurance market and potentially dealing the law a fatal blow. A decision likely will not be announced by the Supreme Court until May or June.

The liberal justices came out of the gate with tough questions for Michael Carvin , the lawyer challenging the Obama administration's interpretation of the law, which is that in states that choose not to set up their own insurance exchanges, the federal government can step in, run the exchanges and distribute subsidies. Arvin argued it was clear from the text of the law that Congress authorized subsidies for middle and low income individuals living only in exchanges "exstablished by the states." Just 16 states have established their own exchanges, but millions of Americans living in the 34 states are receiving subsidies through federally facilitated exchanges.

But Justice Elena Kagan, suggested that the law should be interpreted in its "whole context" and not in the one snippet of the law that is the focus of the challengers. Justice Sonia Soto mayor was concerned that the challenger's interpretation of the law could lead to "death spirals" in states that hadn't established their own exchanges. Justice Anthony Kennedy, another potential swing vote, asked questions that could be interpreted for both sides, but he was clearly concerned with the federalism aspects of the case. He grilled Carvin on the "serious" consequences for those states that had set up federally-facilitated exchanges. At one point he told Carvin that his argument raised "a serious constitutional question."

President Obama has expressed confidence in the legal underpinning of the law in recent days."There is, in our view, not a plausible legal basis for striking it down," he told Reuters this week. Wednesday’s hearing marks the third time that parts of the health care law have been challenged at the Supreme Court. In this case -- King v. Burwell -- the challengers say that Congress always meant to limit the subsidies to encourage states to set up their own exchanges. But when only 16 states acted, they argue the IRS tried to move in and interpret the law differently.

Republican critics of the law, such as Texas Sen. Ted Cruz, filed briefs warning that the executive was encroaching on Congress' "law making function" and that the IRS interpretation "opens the door to hundreds of billions of dollars of additional government spending."In a recent op-ed in the Washington Post, Orrin Hatch (R-Utah) and two other Republicans in Congress said that if the Court rules in their favor "Republicans have a plan to protect Americans harmed by the administration's actions."Hatch said that Republicans would work with the states and give them the "freedom and flexibility to create better, more competitive health insurance markets offering more options and different choices."

Via: http://www.cnn.com/2015/03/04/politics/obamacare-supreme-court-oral-arguments/index.html