by Patrick Appel

Austin Frakt looks ahead:

Though some provisions begin sooner, full implementation will not be achieved until 2014. Between now and then there will be two congressional election cycles, two congressional sessions, and one presidential election. Given the controversial nature of some elements of reform, the slim margin by which it will pass (assuming it does), and the political importance of its success for Democrats, it is clear that changes will be proposed. Some may be deadly.

It is possible to kill health reform without repealing it, which would be politically difficult. Death by underfunding or otherwise undermining its intentions is politically possible and even likely if Republicans regain control. In large part, the success of health reform or at least successful implementation of it depends on winning and re-winning debates over its provisions.

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