A different prong of Obama's coverage expansion seems to be doing fairly well. It's an expanded version of Medicaid, embraced so far by 25 states and the District of Columbia. An informal survey of 14 of those states by The Associated Press shows that at least 240,000 people had enrolled in or applied for the expanded safety-net program as of the third week of October.
Private coverage is what interests Cecilia Fontenot of Houston, a part-time accountant in her early 60s. She has diabetes, high blood pressure and high cholesterol. Though she manages well, she has been unable to find affordable insurance. Under Obama's law, insurers will not be able to turn away people with medical problems or charge them more.
Fontenot gave up on HealthCare.gov and instead applied through a call center on Oct. 19.
"They said it may take a while because so many people had called in," Fontenot explained. "I'm a very patient person, and I'm looking forward to getting that insurance."
She wants a plan that covers a better diabetes drug than the one she can afford now by paying out of pocket. Her doctor has also recommended a high-tech imaging test for a breast lump.
WONDERING WHETHER COVERAGE WILL CHANGE
Americans are still divided over the Affordable Care Act, with negative views outweighing positives. But they also lean against repealing it. The final judgment may be in the hands of people who now have employer-provided health insurance. They're about half the population, and they've noted Obama's assurances that their coverage won't be disrupted.
Up to now, the changes for employer plans have been incremental. They tend to expand benefits, not take things away.
For example, young adults can stay on a parent's coverage until they turn 26. Employers cover women's birth control as a preventive service, free of charge. Screening tests such as colonoscopies are also free.
But cost control provisions, mainly a tax on expensive insurance plans that starts in 2018, are converging with the long-standing push by employers to tame health costs. Some companies have raised deductibles and copayments for employees, saying they need to scale back to avoid tangling with the coming tax. Others are giving employees a fixed amount of money to shop in private health insurance markets that resemble those created by the law.
Expect cutbacks to be blamed on the law. Sorting out whether that's warranted may be difficult.
"What the Affordable Care Act did was give companies a very convenient excuse to say 'Oh, gosh, we really have to get serious about insurance costs,'" said Paul Keckley, an independent health benefits consultant. "I think there's a bit of a bob and weave. The ACA was a convenient excuse for doing what (corporate) human resources departments have been calculating to do for years."