Three months after the $938 billion health care bill was signed into law, questions abound about whether the Obama administration can meet all the deadlines in the massive law while dealing with the political pressures of Congress.
Meanwhile, the impact on Americans' health insurance costs remains negligible, and premiums are actually rising as many Americans lose their coverage in a troubled job market. About three in four Americans who buy their own insurance reported seeing an uptick in their premium prices, according to a Kaiser Family Foundation survey released this month.
Republicans have accused the Department of Health and Human Services (HHS) of missing key deadlines, such as one requiring the establishment of an advisory committee for an advertising campaign to educate young women about breast cancer. The deadline was May 22, but members have yet to be selected.
HHS was also ordered to establish a government task force by May 7 to come up with a strategy to improve health care programs in Alaska. The agency has moved forward in the process but the task force hasn't been selected yet.
HHS has successfully met bigger deadlines, and even beaten some of them. Seniors who fall into the "doughnut hole," when they hit the cap for their prescription drug coverage, have begun to get $250 rebate checks.
The requirement allowing young adults under age 26 to stay on their parents' health plans has also been implemented ahead of schedule.
"HHS has met and beaten the deadlines required by the new law, with several important benefits becoming a reality well in advance of their deadlines," HHS spokeswomen Jessica Santillo told ABC News. "HHS will continue working efficiently and effectively to get the benefits of the new law to the American people quickly and responsibly."
But concerns remain high as to whether HHS -- which bears most of the burden of implementing the reforms in the health care law -- can effectively meet all of its objectives without making errors.
The process for making rules is long and rigorous, and new rules often have to go through multiple agencies and departments. It will also take many more people with specific expertise to carry out the various parts of the law, and hiring in itself can be a slow process in the federal government.
"The average rule takes 18 months, which means that there are many of those that take two or three years to do, because they have controversy or they require integration with some other rulemaking process. So this is a tsunami of rulemaking that has tipped the Department of Health and Human Services," said Michael Leavitt, HHS secretary under former President George W. Bush.
"The political pressures that are inevitably going to come to bear here, from inside and outside of the administration, it's a recipe for uncertainty," he added.
Some of the changes have already raised red flags. Small businesses have expressed concern about the "grandfather rule," designed to keep insurance plans that were in place by March 23 remain with minimal changes.