The once-steady stream of regulations and rules from the Obama administration — instructions for insurance companies, hospitals and states on how to put the law in place — has slowed to a trickle in recent months in an attempt to avoid controversies before the election. Many states, too, have done little public work to avoid making the law an election issue for state officials on the ballot.
But work has been going on behind the scenes — both in the Department of Health and Human Services and at the state level. As soon as Wednesday, the gears and levers of government bureaucracy are likely to start moving at full speed again.
HHS is expected to begin to release the backlog of regulations. And the states will quickly face a Nov. 16 deadline to tell the Obama administration whether they’ll implement a health insurance exchange — a key part of the law about where consumers will purchase health insurance after 2014.
If Obama wins, that work is likely to continue through the early years of his second term. Democrats will want the law put in place as quickly as possible. They face a late 2013 deadline to have the exchanges ready to go.