One of the main components of the Affordable Care Act took effect Jan. 1, requiring Americans to have some form of health coverage.
Many Americans already carry private health insurance through their employers and did not have to enroll for coverage. But more than 7 million Americans signed up for private health coverage through the law, also called Obamacare, according to the White House.
Having had a quarter of the year to experience the impact of the legislation, the health care industry still has questions.
"There's no question that all of us are seeing higher costs associated with Obamacare," said Gene Diamond, Franciscan Alliance Northern Indiana Region CEO. "And there's still lots of questions about whether the people participating through the exchanges are actually covered."
If people enrolled but have not paid their premium, hospitals won't get paid, Diamond said.
"So far, the effects have been marginal," he said. "The bigger issue for us is constantly geometrically increasing regulation, new ways of making the oversight we're subjected to more intense."
Another component of the Affordable Care Act affecting many business owners is approaching.
The law requires employers with 50 or more full-time equivalent employees to offer affordable health care to employees. That requirement was delayed a year, giving employers until 2015 to comply.
Business leaders have other health-related costs to consider.
Rex Richards, executive director of the Valparaiso Chamber of Commerce, is concerned about rising insurance premiums, which will come up for renewal at the end of the year.
"The indications that we get, are that the premiums are going to increase 30 percent," he said. "That affects small business. That affects medium-sized business. And, that affects large business.
"And the increase – we're informed by our health care carrier – is the impact of the federal legislation," he said.
Richards said the chamber had seven employees a month ago. One left, and Richards was left to decide whether to hire a replacement. He decided not to, because his contact at UnitedHealthcare warned of a 30 percent increase in premiums.
"It's having an effect on companies' decisions on whether they want to increase their workforce," he said.