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TODAY   |  January 02, 2014

Obamacare coverage goes into effect

Nearly four years after being signed by President Obama, the Affordable Health Care Act is in effect, with 2 million Americans already signed up. NBC’s Tom Costello reports.

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>>> on this first business day of the year, patients are covered under obamacare. there are challenges, nbc's tom costella is in walling. good morning to you.

>> reporter: they give employers a temporary xems xem slun to parts of the law that provide employers to provide insurance coverage which includes contraception. those groups opposed that requirement on religious and moral grounds. meanwhile, obamacare's nins coverage is in effect this morning. today, nearly four years after president obama signed the affordable care act into law, after a general election turned into a referendum --

>> repealing and replacing obamacare.

>> reporter: then a re-election victory. a supreme court verdict.

>> the supreme court has upheld the health care case.

>> reporter: a government shutdown.

>> obamacare is a train wreck.

>> reporter: and a disastrous rollout, obamacare this morning is in effect. at least 2 million americans already signed up. among them, this family in delaware. both self-employed artists. kathy was stuck in an old policy because of a pre-existing condition. no longer.

>> it used to be if you had a job, you had health benefits . that's no longer the case.

>> reporter: but the rollout remains trouble, persistent computer errors , millions kicked off their insurance policies that didn't meet the new minimum standards and utter confusion in the marketplace. in michigan, the second largest insurer says only a small handful of uninsured have signed up.

>> as a country, we need to reevaluate the plan we put forward and consider what adjustments we need to make in order to make a difference.

>> reporter: but any fixes would require congressional compromise and 2014 is an election year.

>> i think the administration has succeeded in averting the catastrophe they seemed to face in october. but whether the system will really work as people begin to try to use it only time is going to tell us trot concern that the newly insured may not appear in a proper computer databases. they may not have their insurance cards. pharmacy, hospitals, doctor's offices may struggle to pros claims is. nearly all sides expect it will be a rough few weeks or months. they need more americans to sign up by april.

>> matt, thanks,.

>> before you get to your headlines, you cover the white house after four years, this roller coaster ride of obamacare and still challenges?

>> i think they're celebrating they have 2 million people who have signed up. the next will be about access. the question is beginning today, these newly insured show up at pr and doctor's offices. they will find out whether they got the coverage they want and can see the doctors they want and hopefully find out whether they can afford it. what the real costs are.

>> to be continued.