Amy Braun-Gross is counting the hours until January 1.
It's not her birthday or her anniversary.
January 1 is the day that marks the first time ever she will be able to get insurance.
Like more than 48 million other Americans, the Wisconsin stay-at-home mom does not have insurance to pay for doctor bills if she gets sick. It's particularly disconcerting when she thinks about her husband, Chris, who runs a tree-cutting business. Being an arborist is physically demanding. He has fallen out of trees.
"You know something as simple as a sprained ankle, none of that is covered right now, none of it," Braun-Gross said. "To add the cost of that to the debt we already have, we'd basically be up a creek."
Braun-Gross and her husband have tried to get insurance before, but they don't qualify. They both work hard, and they're college educated. But because of some pre-existing conditions, including Braun-Gross' weight, insurance companies haven't wanted their business.
Obamacare will change all that. The law forbids insurance companies from rejecting people like Braun-Gross because of their pre-existing conditions. To make that affordable, though, one of the most controversial parts of the Affordable Care Act is about to go into effect: By 2014 every American, with some very few exceptions, will have to have some form of health insurance or be fined.
The idea is that more healthy people will buy insurance, and the money the insurance companies save on them will cover the costs of insuring the older and sicker people who will now be in the insurance system.
Employers will provide insurance for three out of every five Americans in 2014, according to the Congressional Budget Office. Another 12% get it through Medicaid or the Children's Health Insurance Program.
But for those Americans without insurance, a central feature of Obamacare -- health insurance marketplaces, also known as exchanges -- can make a big difference in helping them find a plan. Many are eligible for government help to pay for those plans.
With so many politicians fighting over this controversial legislation, and with all the computer glitches, the details about how to sign up may have gotten a little lost. So, here is what Braun-Gross and the other millions of Americans like her need to know.
Open enrollment runs between October 1 and March 31. Plans bought through the exchanges this year won't start until January 1.
In most of the country December 23 is the cutoff date if you want your plan to start on January 1. America's Health Insurance Plans, the health insurance industry trade group, said consumers now have until January 10 though to make their first payment for coverage retroactive to January 1. If you sign up after that in January or February your coverage will start the following month. The enrollment period closes March 31 and won't re-open until October 15.
When Massachusetts rolled out a similar health insurance mandate in 2007, the biggest spike in enrollments came in the two months before people would be charged a penalty for not having coverage, according to Jon Kingsdale, who ran the state's health benefit exchange then. He also noticed many people came back to the state's website to evaluate the potential plans more than once.
The experts advise you to take your time. Comparison shop to find the policy that works best for you.
Where to start
If you have Internet access, start with the Web. Healthcare.gov will have the information you need. The government site will link to where you sign up for the program.
There have been challenges with these websites, but the Obama administration said December 16 that the issues should be resolved.
If you can get into the website, go first to "get insurance." That tab will get you to a page that will walk you through whatever marketplace is available to you. Some states set up their own; the federal government runs the rest. On this site you can also compare the plans available in your area.
You may also want to see if you are eligible for Medicaid here. So far, 26 states have decided to expand who is eligible for the federal government-funded health program for lower income families and individuals. Four others are currently considering expansion.
You can also enroll by mail.
The government has set up call centers to help people with open enrollment. Call 1-800-318-2596 (TTY: 1-855-889-4325). The number is staffed around-the-clock. Information is available in more than 150 languages.
There will also be specially trained advisers in communities. These "navigators," as they are known, can help you in person. There will also be federally authorized marketplace-designated organizations. They will be based in community health centers, at the mall, in drug stores and in churches. Depending on state law, traditional agents and insurance brokers can also help.
If you would like to find a navigator, go to Localhelp.healthcare.gov. The government site lets you plug in your ZIP code and it will give you the closest location to get help. The website will list the phone number, the address, the e-mail address, the website address, the office hours, and details on how they can help.