Obama's health plan set for launch, ready or not

The success of the health care overhaul could largely define his legacy

Starting on Tuesday, an estimated 50 million Americans who don't have health insurance can start signing up for coverage as the core of President Barack Obama's overhaul takes hold. Subsidies will be available to help those with lower-incomes pay for insurance. And on Jan 1, people will no longer be denied coverage because of previous illnesses.

Yet Americans are hardly celebrating.

Polls show most of them don't like the program. Many object to requirements that all Americans have health insurance or face fines. Some employers, the main provider of health insurance in the US, are citing the program as they cut back on coverage contrary to Obama's promise that people could keep their coverage without worrying about anything changing.

Republicans have waged an unrelenting battle to repeal the law, claiming the program will cost American jobs. They have had no success so far, with Democrats controlling the Senate and White House.

But even without Republican actions, Obamacare, as the program is commonly known, is already off to a rocky start. Obama has had to delay a key part for one year: a mandate that large employers provide health care coverage. On Thursday, the government announced delays for small businesses seeking to buy insurance online.

"This law is a mess. It needs to go," the Senate's top Republican, Mitch McConnell, said in a speech Thursday. "It's way past time to start over."

In the run-up to Tuesday's deadline, Obama has been trying to boost support for the plan. In a speech Thursday just outside Washington, he rejected Republican claims that it will further damage an economy that still hasn't fully recovered from a lengthy recession.

"The evidence is that it's not going to hurt the economy," he said. "Obamacare is going to help the economy. And it's going to help families and business."

The success of the health care overhaul, Obama's major legislative achievement, could largely define his legacy. Obama won passage early in his presidency while Democrats controlled both chambers of Congress. States challenged its constitutionality but the US Supreme Court narrowly upheld the core of the program.

The United States has long been the only major developed nation without a national health care system. Even with the Affordable Care Act, as the program is formally called, taking effect, it will not have a single, government-run health insurance covering all Americans.