The Patient Protection and Affordable Care Act has had a rocky start. Its website, healthcare.gov, has been plagued by technical issues during its first month in operation and now many claim they are being dropped from their previous health plans. The aim of the Patient Care and Affordable Care Act, often shortened to the Affordable Care Act (ACA) and known colloquially as Obamacare, is to provide more affordable healthcare insurance to a wider portion of the American populace. The ACA will expand Medicaid in 25 states (Missouri is not expanding) and has set up the aforementioned healthcare.gov, an online marketplace for individuals and small businesses without insurance Whether the law can achieve its lofty goal of providing insurance to more Americans is a large source of debate among Americans.

President Barack Obama spent much of his 2008 presidential campaign endorsing healthcare reform, which came into actuality in the form of the ACA, his signature legislation.

One key component of Obamacare was the creation of an online marketplace that would help Americans register and apply for the new insurance program. A major provision the Supreme Court struck down was the requirement that Medicaid be expanded to include those with incomes up to 133 percent of the poverty line.

The health exchange websites were launched on Oct. 1, but have been largely unable to handle the large amounts of users. Thirty-six of the state exchanges are run by the federal government (including Missouri’s), and state governments operate 14. Although many fixes have been put into effect since then, many have still had difficulty with starting and accessing accounts and applying for insurance.

The White House has stated that many of the problems stem from higher than expected visits to the website, but recent documents show that before the launch the site was only able to host 1,100 users.

The website marketplaces largely depends on healthy, young people signing up for insurance to help “subsidize” older, less health individuals. Many are worried about the paltry early enrollment numbers- 700,000 have applied for insurance, while the government has a stated goal of enrolling 7 million by the time enrollment ends in March- are a sign that these young people have not taken to signing up for Obamacare.

The controversial nature of the ACA along with its slow launch has only increased criticism of the law. Many Republicans in both the House and the Senate have called Obamacare’s effectiveness into question, including Senate Minority Leader Mitch McConnell.

“I don’t think anybody could administer this law. I think it can’t possibly work,” McConnell said. To add fuel to the fire, President Obama recently apologized to the thousands of Americans who say they’ve been dropped from their health plans since the law has been implemented. He explicitly promised this would not happen during the debate over the ACA in 2009-10.

Even some Democrats have been unsatisfied with the law. Dick Durbin, Senate Majority Whip, told the administration and its agencies to “fix it.”

One of the most recent attempts to derail the ACA came during the partial government shutdown. During this shutdown multiple senators, most prominently Ted Cruz (R-Texas), threatened to block the passage of a budget plan without an agreement to defund the ACA. The effort helped lead to a 16-day partial shutdown.

As the Affordable Care Act continues to be phased in through 2020, opposition to the law will likely continue.

As Real Clear Politics showed in an aggregation of recent polls, approximately 42 percent of Americans support Obamacare, while 51 percent oppose it.

While the ACA remains a controversial and complicated law, it is ultimately just a beginning to the massive health care reform that must take place in the United States over the coming decades.

The U.S. spends 17 percent of its GDP on health care, considerably more than any industrialized country, while 15.4 percent of Americans remain uninsured. The ACA is but the first step in addressing these numbers and the full effects of Obamacare’s approach to American health insurance will be demonstrated in the coming years.