WASHINGTON (AP) - The Supreme Court signaled Wednesday that it could throw out other key parts of President Barack Obama's health care law if it first finds the individual insurance requirement unconstitutional.
On the third and last day of arguments, the justices appeared to accept the administration's argument that at least two important insurance changes are so closely tied to the insurance requirement that they could not survive without it.
Less clear was whether the court would conclude the entire law, with its hundreds of unrelated provisions, would have to be cast aside.
The justices also spent part of the day considering a challenge by 26 states to the expansion of the Medicaid program for low-income Americans, an important feature in the effort extending health insurance to an additional 30 million people.
The court's liberal justices made clear they will vote to uphold the Medicaid expansion, which would take in 15 million people with the federal government paying almost all the costs.
Justices Sonia Sotomayor, Elena Kagan, Ruth Bader Ginsburg and Stephen Breyer voiced strong disagreement with the states' contention that the expansion of the joint state-federal program is unconstitutionally coercive.
The day's earlier session was unusual in that it assumed an answer to the central question in the historic health care case: that the requirement that Americans carry health insurance or pay a penalty will be struck down. In fact, if they follow their normal practice, the justices have not even met yet to take a preliminary vote in the case.
In their questions, the liberal justices took issue with Paul Clement, the lawyer for the states seeking to have the Patient Protection and Affordable Care Act tossed out in its entirety.
"What's wrong with leaving this in the hands of those who should be fixing this?" asked Sotomayor, referring to Congress.
But Clement said the court would be leaving "a hollow shell" if it decided to excise the several key provisions. "The rest of the law cannot stand," he contended.
Chief Justice John Roberts and Justice Anthony Kennedy also asked hard questions of Deputy Solicitor General Edwin Kneedler that indicated they are at least considering Clement's arguments. Kneedler said the only other provisions the court should kill in the event the mandate is stricken are revisions that require insurers to cover people regardless of existing medical problems and limit how much companies can charge in premiums based on a person's age or health.
Justice Antonin Scalia suggested many members of Congress might not have voted for the bill without the central provisions, and he said the court should not go through each and every page to sort out what stays and what goes.
The first two days of fast-paced and extended arguments have shown that the conservative justices have serious questions about Congress' authority to require virtually every American to carry insurance or pay a penalty.
The outcome of the case will affect nearly all Americans and the ruling, expected in June, also could play a role in the presidential election campaign. Obama and congressional Democrats pushed for the law's passage two years ago, while Republicans, including all the GOP presidential candidates, are strongly opposed.
But the topic the justices took up Wednesday only comes into play if they first find that the insurance mandate violates the Constitution.
The states and the small business group opposing the law say the insurance requirement is central to the whole undertaking and should take the rest of the law down with it.
On Tuesday, the conservative justices sharply and repeatedly questioned the validity of the insurance mandate.
If the government can force people to buy health insurance, justices wanted to know, can it require people to buy burial insurance? Cellphones? Broccoli?
The court focused on whether the mandate for Americans to have insurance "is a step beyond what our cases allow," in the words of Justice Kennedy.
"Purchase insurance in this case, something else in the next case," Chief Justice Roberts said.
But Kennedy, who is often the swing vote on cases that divide the justices along ideological lines, also said he recognized the magnitude of the nation's health care problems and seemed to suggest they would require a comprehensive solution.
Kennedy and Roberts emerged as the apparent pivotal votes in the court's decision.