Millions of Americans will learn on Tuesday what President Barack Obama's landmark healthcare law actually means for them, as the administration opens new insurance marketplaces in 50 states despite the government shutdown.
The launch marks a milestone for Obama's signature domestic policy achievement, which aims to provide subsidized healthcare to millions of the uninsured, the most ambitious U.S. social program since Medicare was introduced in the 1960s.
The marketplaces, or exchanges, require health plans to provide a broad range of essential benefits that were not necessarily part of individual policies in the past, including mental health services, birth control and preventive care. The coverage is linked to other insurance market reforms and new consumer safeguards including a ban on discrimination based on gender and health history.
It also mandates that Americans obtain insurance or pay a fine.
"Nothing like this has ever existed before," said U.S. Health and Human Services Secretary Kathleen Sebelius.
Republicans have fought for months to delay or stop Obamacare, most recently triggering a shutdown of the federal government on Monday night by insisting that a routine funding measure include a delay in Obamacare, which the Democratic-controlled Senate rejected.
Officials running the new exchanges braced for technical glitches that could hamper the enrollment effort.
But the president said that whatever the outcome of talks in Congress, the healthcare reform launch would proceed.
"The Affordable Care Act is moving forward. That funding is already in place. You can't shut it down," Obama resolutely informed his Republican opponents in a televised statement at the White House on Monday.
As many as 7 million Americans are expected to sign up for insurance in 2014 through the exchanges, which open for enrollment into new insurance plans on Tuesday and will accept applications through March 31. An additional 8 million people are expected to receive health benefits through an expansion of the government's Medicaid program for the poor.
Republicans have blamed Obamacare's requirements for pushing up the cost of health insurance for business and individuals, a claim the Democrats deny.
"What I want is to keep the government running and at the same time to deal with the harms, the millions of Americans