The U.S. Supreme Court justices appeared sharply divided Wednesday over President Barack Obama's controversial healthcare law. The sticking point: tax subsidies.
Attorneys on both sides were grilled by the justices in this latest challenge to the Affordable Care Act.
Some believe a ruling against the administration could mean the beginning of the end for Obamacare. Four words could doom the entire 2,000-page law on a technicality: "Established by the state."
Opponents say the law required individual states to create their own health care exchanges. But since 34 states chose to not do that, the Obama administration created a national healthcare exchange.
If the court decides that violates the law, 5 million to 7 million Americans might not be eligible to receive subsidies from the federal government to buy health insurance.
"If the court were to rule that the administration's interpretation was wrong, then there would be 34 states where people would no longer be able to get these tax credits for buying coverage on the exchange," Ed Haislmaeir, a senior research fellow at the Heritage Foundation, explained.
If those subsidies go away, experts say only the sickest people would participate in the exchanges and premium rates would skyrocket, sending Obamacare into a death spiral.
Lawyers for the government will argue against a literal interpretation of the law, saying the intent is clearly to help people in all 50 states get affordable health care coverage.
"There's breast cancer in my family, so for me it was very important to get the Affordable Care so that I could go and get all my preventive care," said Alicia Elatassi, who's enrolled in Texas.
After narrowly surviving a constitutional challenge in 2012, the fate of Obamacare is once again in the hands of nine justices. Some Republicans say either way they will keep working to repeal the law.
"It's bad for patients, bad for the providers, the nurses and doctors who take care of them and terrible for taxpayers," Sen. John Barrasso, R-Wyo., told NBC's "Meet the Press."
"This is just one more example of a law that has all sorts of unintended consequences and adverse effects for all sorts of people," Haislmaier said.
The Supreme Court's decision is expected to come down in June.