"The administration will be reluctant to delay because so much work has gone into this and they're in a sense it wouldn't be fair to the insurance companies that have been working hard to compete on the exchanges and it wouldn't be fair to the states that have moved ahead putting everything in place. But that idea is going to be floated," she says.
The exchanges are supposed to generate about $55 billion in premiums in 2014, with most of that money coming from federal subsidies to help consumers offset costs.
"In that first year nine of 10 people shopping on the exchange will be shopping with a subsidy and that is revenue for insurance companies," Connolly says. "Also it's important money for providers because hospitals and large health systems that have big uncompensated care burdens want to transition those patients into coverage. So while there will be voices in support of delay there will be a number of voices on the other side."