A lot has changed since then. President Obama was re-elected in a campaign that featured sharp criticisms of "Obamacare" from Republican challenger Mitt Romney, who vowed to repeal the law if elected. He was not elected.
And now, the states that decline to expand their Medicaid rolls risk losing some of the estimated $642 billion in direct federal aid that will be made available over the next decade.
Paul Keckley, executive director of the Deloitte Center for Health Solutions, says polls show that attitudes have calcified over the last two years since shrieking protesters disrupted town hall meetings across the nation after PPACA was signed into law.
Since then the America public has held firm in its views of Obamacare. "About one-third thinks it's the second coming and one-third thinks it is the apocalypse and one-third doesn't care," he says.
Obamacare supporters in Congress were buoyed by their strong performance in last week's elections and are expected to be more aggressive in promoting and defending the plan over the next two years.<