Monday is the deadline for people who want to buy health coverage through the insurance marketplace and have that coverage start Jan. 1.
The Affordable Care Act requires Americans to have health care coverage in 2014.
Most carry insurance through employer or government programs, but the U.S. Census Bureau reported about 48 million Americans were uninsured in 2012.
The law, often called Obamacare, has undergone numerous adjustments and delays -- as well as technical problems -- since open enrollment began Oct. 1.
Beth Wrobel, CEO of the federally qualified health center HealthLinc in Valparaiso, subscribes to state and federal email lists and noted the frequent changes.
“I was giving a talk to the Lake County Bar Association,” she said. “On my way, a date changed that was in my PowerPoint.”
But the changes are signs higher-ups are paying attention, she said.
“I'm actually more confident, because they're listening,” she said.
The health insurance industry Wednesday gave enrollees extra time to pay. Consumers who choose a plan by Monday will have until Jan. 10 to pay the first month's premium, instead of the New Year's Eve deadline, which the government previously set.
The payment deadline extension allows consumers to have coverage retroactive to Jan. 1.
Lauren Lamb, outreach and enrollment manager for HealthLinc, said the most common questions she fields are about payment.
"They say, 'I don't have any money. How am I going to afford this?'" Lamb said.
The Affordable Care Act allows states to expand Medicaid eligibility to Americans earning up to 133 percent of the federal poverty level. The federal government will pay 100 percent of the cost of new enrollees the first three years, then gradually decline to 90 percent by 2020.
Indiana opted against the expansion. Instead, it received federal approval for a one-year extension to the government-supported health insurance program called Healthy Indiana Plan. About 11,000 low-income Hoosiers enrolled in HIP will be forced out, because participants cannot exceed the federal poverty level.
Indiana has about 880,000 uninsured residents, 500,000 of whom are expected to buy federally subsidized health insurance -- leaving 330,000 residents uninsured.
"The lack of Medicaid expansion in Indiana is very disheartening," Wrobel said.
To meet requirements of the law, uninsured Americans have until March 31 to register for health care.
Those who sign up by Jan. 15 will have coverage in February; those who sign up by Feb. 15 will begin coverage March 1; and people registering in March will be covered starting April 1, according to the most recent information. After a hiatus, open enrollment begins again Nov. 15, 2014.
Plans can be adjusted at any time when a life event — such as a child birth or job loss — occurs.
Those who were previously uninsured, especially people with a preexisting conditions, are grateful for the coverage, Lamb said.
"People, for the most part, are thrilled at the anticipation of it," she said.
The technical obstacles at the start of open enrollment had navigators switching to paper applications, Wrobel said.
“Two weeks ago, we switched to just online, once we knew it was good and we weren't getting kicked off," she said. "We've seen every day that it gets better.”
Wrobel said it is important people call their doctors and hospital of choice to ensure the insurance plan they buy is accepted by those health care facilities.
For questions or to register for health care online, visit www.healthcare.gov. Or call (800) 318-2596 for more information.