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Obama’s troubled health care law at a crossroads

January 1, 2014

WASHINGTON (AP) — All things good, bad and unpredictable converge Wednesday for President Barack Obama’s signature health care overhaul as the law’s major benefits take effect, along with an unpopular insurance mandate and a risk of more disruptions.

The law requires virtually every American to get health coverage, either through an employer, a government program, or by buying a plan directly.

The HealthCare.gov website now appears to be largely fixed, with more than 2 million people enrolled, the Obama administration said Tuesday. But insurers say they are still receiving thousands of erroneous sign-ups from the government.

That means patients who signed up could go for a medication refill — or to the emergency room — in the coming months, only to be told there is no record of their coverage.

Legal challenges still lie ahead for the health care law. Supreme Court Justice Sonia Sotomayor, acting Tuesday night on a request from an order of Catholic nuns in Colorado, blocked implementation of portions of the law that would have forced some religion-affiliated organizations to provide health insurance for employees that includes birth control. In a separate filing earlier Tuesday, several Catholic groups asked the Supreme Court to take similar action for similar reasons.

Obama had envisioned that the arrival of the Affordable Care Act’s major benefits in 2014 would showcase his philosophy that government can and should smooth the rough edges of an unforgiving economy for struggling working people.

The goal was that in a midterm election year, Democrats would be able to point to millions of newly insured Americans.

But the Republican portrayal of “Obamacare” as inept and out of control appears to be unfolding as well.

Although the stated goal of the law was to cover the uninsured, at least 4.7 million insured people had current individual policies cancelled that didn’t measure up to new requirements. That forced an apology from Obama, who had famously promised that if you like your health plan, you can keep it. It remains to be seen how many of those people suffer a break in coverage.

It may take years to settle the nation’s divisive debate over health care.

For now, administration officials say they are just focused on getting through the March 31 end of open enrollment season. People who enroll by that date will not face the law’s tax penalty for remaining uninsured.

The two main objectives are to minimize any coverage disruptions around the new year, and launch a big push to get younger, healthy uninsured people to sign up. That’s key to the law’s long-term success, as they will help pay for coverage for others.