The uncertainty surrounding the exchanges has many Democrats nervous, including retiring Sen. Max Baucus, D-Mont., one of the architects of the overhaul. He said last month that the health care law is heading for a "train wreck" because of a bumbling implementation.
The president conceded last week that there would be "glitches and bumps" as the final phases of the health care law — formally the Affordable Health Care Act — are rolled out. But he said most people will be unaffected by the changes that are still to come.
"For the 85 to 90 percent of Americans who already have health insurance, this thing has already happened," Obama said. "Their only impact is that their insurance is stronger, better, more secure than it was before. Full stop. That's it. They don't have to worry about anything else."
Many Republicans strongly disagree, saying the full impact of the law will ripple throughout the economy. House Republicans announced this week that they planned to hold a vote on repealing the overhaul — the 37th time the House has voted to repeal all of part of the law. The Democratic-controlled Senate has ignored those votes each time.
House Speaker John Boehner, R-Ohio, acknowledged that the move was largely political, noting that there were 70 new members of the House this year who haven't had an opportunity to register a vote against the health law. As for why Republicans are intent on repealing the law rather than trying to amend its pieces, Boehner said, "I don't believe there is a way to fix this and make it acceptable to the American people."
Administration officials insist it's bad politics for Republicans to keep pressing for repeal. They say the American people don't want to harp on old issues, and cite the law's popularity among young people, blacks, Hispanics and women — all demographic groups the GOP has struggled to attract in recent elections.