The clock is ticking for US President Barack Obama's health care reform law after the supreme court heard three days of arguments on his signature domestic policy.
One of the main decisions for the nine-member court is whether to overturn a key provision of the law that requires Americans to buy health insurance if they are not covered by their employers.
A decision is expected before the court's term ends in late June, as the presidential election is kicking into high gear.
Many voters on both sides feel strongly about the law, and bringing it back into public view at that time would be an embarrassment for the president while energising both supporters and opponents.
The measure requiring the purchase of health insurance is deeply unpopular with the American public. Only 28 per cent support the so-called individual mandate and 66 per cent oppose it, in a United Technologies/National Journal poll released on Tuesday. The broader health care measure is more popular, with 43 per cent in favour and 46 per cent opposed.
Observers have pointed to the ideologically divided court's traditional swing votes. CNN supreme court reporter Jeffrey Toobin called the proceedings a "train wreck" for the government.
Justice Anthony Kennedy, closely watched as usually the most likely of the court's five conservatives to join the four left-leaning justices in majority decisions, called the law's impact "concerning".
Kennedy said the law's requirement that people buy health insurance would change "the relationship between the individual and government in a fundamental way".
White House deputy spokesman Josh Earnest called it "foolhardy to try to predict the outcome of this decision".
Paul Clement, one of the lawyers arguing against the law at the court, also declined to predict an outcome in the case after arguments wrapped up on Wednesday.
Obama pushed for the law to help an estimated 30 million people without health insurance pay for care and address soaring costs in one of the few wealthy nations that do not guarantee insurance coverage to all citizens.
But conservative opponents of the law argue that Congress overstepped its boundaries by requiring citizens to purchase a product. Clement stressed the government can only regulate ongoing commerce, not force citizens to engage in it.
A rally of conservative Tea Party supporters outside the Capitol to protest the law cheered the prospect both that it could be overturned and Obama could be ousted from office. The movement within the Republican Party was formed in part out of frustration over the health care legislation and helped return control of the lower House of Representatives to the party in 2010.
Liberal defenders of the measure meanwhile argued that elected lawmakers, not appointed judges, should make decisions about policy.
"There is a reason why the Constitution leaves difficult questions of economic policy to elected officials and not to unelected judges," the Centre for American Progress said.
Despite the speculation about the law's eventual fate, the White House insisted that it would hold up to scrutiny and that no contingencies were being developed.
"We're confident that the legislation is constitutional," Earnest told reporters when asked about future plans. "You know, if there is a reason or a need for us to consider some contingencies down the line, then we'll do it then."
Regardless of the outcome, Obama is sure to defend the law on the campaign trail as a key piece of his legislative legacy, while his Republican challengers are committed to repealing the measure if need be.
Even so, Republican frontrunner Mitt Romney will be forced to denounce Obama's effort while at the same time defending reforms he enacted as governor of Massachusetts that served as a model.
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