The ball drop in Time Square ushered in a new year and sent the memories of 2013 to the recesses of our minds. The President and his Administration were probably celebrating the end of a bruising year thanks to scandals, contentious federal battles, embarrassing moments, and the botched rollout of his signature healthcare legislation.

The website appears to be working better and over one million Americans have “enrolled” in ObamaCare. That million-person figure is questionable because Health and Human Services can’t confirm if those enrollees have actually paid their first month’s premium, which is how insurance companies define enrollment, but we’ll leave that point aside for now.

If I were POTUS and sympathetic members of Congress (especially those up for re-election in November), I would hold off on celebrating too much. The Affordable Care Act is now in full effect with some of the most pernicious aspects taking affect starting today.

Lanhee Chen discusses some of the challenges ahead for Americans thanks to ObamaCare:

First, some of Obamacare’s least popular provisions go into effect in 2014. This includes a new $60 billion tax on health insurers, which will be levied relative to premiums collected and directly passed on to consumers. And, of course, Obamacare’s requirement that individuals secure health insurance coverage (or pay a tax penalty) kicks in during the coming year as well.

Second, millions of Americans who buy their coverage on the individual market or get it through small employers will be shocked by just how much their premiums go up in 2014. The young and healthy will be especially susceptible to this rate shock, and this in turn will further drive them away from purchasing coverage in future years…

Third, not only will millions of Americans on the individual and small group markets who like their plans be unable to keep them in 2014, but many will experience what it’s like to be unable to continue seeing the doctors they know and trust…

Finally, Obamacare’s Medicare cuts will continue to hurt senior citizens. For the 14 million people enrolled in the Medicare Advantage program, the ACA’s $200 billion in cuts over the next 10 years will accelerate in 2014 and have tangible impacts on beneficiaries. Insurers predict that seniors in Medicare Advantage plans will see higher premiums, increased cost-sharing for primary and specialist visits, and limits on the doctors they can see…

Notice some common threads? Welcome to a brave new world of higher premiums and costs (including the mandate penalty), losses of preferred doctors and medications, and overall worse care.

For the millions of Americans who were notified that they were losing their healthcare coverage because their plans were not ObamaCare approved, they have joined the ranks of the uninsured that have opted out of racing to sign up for ObamaCare. And for the million Americans who did sign up, they had better hope that their enrollment information actually got processed by an insurance provider or they will still be uninsured (though the government may force the insurance industry to honor their intentions, thus imperiling the industry’s solvency). Imagine I go to the doctor’s office tomorrow (thinking I am covered under an ObamaCare plan) and in two weeks receive a four-digit bill in the mail for services, because –oops—my healthcare coverage application was never received or could not be processed.

ObamaCare’s drafter’s thought they were smart by delaying the pain of the individual mandate for the start of 2014 – enough time for Obama to be reelected. But it may be a shot in the foot of liberals in the 2014 midterm elections. What progressives have going for them is that the employer mandate was delayed until 2015. That delay postpones the negative impacts on the labor market (including cuts in hours, wages and employment) until after the midterm elections. 

Americans know ObamaCare is an awful law that does nothing to actually reform the problems with our healthcare system. The question is will they do anything to hold accountable those legislators who voted for and supported it come November? Or will they suffer the pain of its affects in silence?

Welcome to 2014!!!