Suppose Romney had won the Republican nomination, and then won the general election by tacking a bit to the center and pledging to go national with his Massachusetts healthcare plan, which he then succeeded in enacting with equal support from Republicans and Democrats (while the rightmost Republicans and leftmost Democrats both voted against it).
Under these circumstances, I seriously doubt that a mandatory insurance rule, substantively identical to that in the healthcare plan that was actually enacted, would face any serious risk of being constitutionally overturned.
UPDATE: See Jack Balkin's take on the actual merits of yesterday's judicial opinion striking down the mandate.
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