Not to mention that it doesn't go fully into play until 2014. At which point Obama's term will be up, so it's quite likely the republicans will try to demolish it when they get into office. Which unfortunately seems rather likely to me, since Obama has only been making subtle changes to the country and therefor nobody notices. There's an overwhelming amount of people who seem to think that Obama hasn't actually done anything, despite the fact that's he's actually done a lot. Just not a lot that's in the public light. So unfortunately it seems to me that the next president being Republican is very likely. And the death of this bill will follow shortly after.