During the 2012 elections, Republicans denounced the President’s Affordable Care Act as pure socialism. They proclaimed that they were going to repeal it if President Obama was defeated at the polls.

However, it would not have been as simple as that. Not only would President Obama have needed to lose, Republicans would have had to pull off a double coup by also taking control of the U.S. Senate. The GOP lost on both efforts. In fact, they lost seats in the Senate. Therefore, whether you like it or not, the Affordable Care Act, infamously known as Obama Care, will proceed as the law of the land.

President Obama proudly defended his landmark health care law during the election. He was proud of his historic accomplishment. He embraced the Obama Care label that Republicans used derisively. It appears that both sides are comfortable and happy referring to the overhaul of the health care system as Obama Care.

Regardless of what you call it, this signature accomplishment of the first Obama administration will be the largest expansion of America’s social welfare net since Medicare and Medicaid were created in 1965. The Supreme Court has upheld the law as constitutional. The implementation therefore is imminent. There is no way for Republicans to derail it. They lost in all of their efforts in 2012.

Federal and state officials must create systems to handle millions of new people thus guaranteeing insurance coverage for all Americans. The vehicle to accomplish this mission will be insurance exchanges in every state. The Health and Human Resources Department of the federal government will run these exchanges in states that refuse to participate.

Open enrollment is scheduled to start October 1, 2013 and coverage will be effective January 1, 2014. In all, more than 30 million uninsured people will receive coverage under the law. About half will get private insurance through the exchanges. The rest will receive help from the federal government through an expansion of Medicaid.

While the federal government will pay virtually all the additional Medicaid costs, the Supreme Court has given the states the leeway to opt out of the Medicaid expansion. Alabama is one of those states that plan to opt out of all of Obama Care. We plan to punt and ignore the mandate. Therefore, the federal government will run our exchange.

Gov. Bentley has been one of the most adamant opponents of Obama Care. He has fiercely denounced and fought the new law. He has been joined by a good many Republican governors, including the chief executives of Texas, Florida and Louisiana.

Only 15 states have established exchanges thus far. It is projected that at least one third of the states, including Alabama will not participate, thus forcing the federal government to step in.

Gov. Bentley has declared that he will not set up a state health care exchange and he will not be for expanding Medicaid under the federal health care law. Bentley still holds to his opinion that the federal law is flawed and unconstitutional. However, the Supreme Court has already ruled on this subject. Bentley also says that a state exchange would cost $50 million to operate. Bentley, who is a physician, decries the act as “truly the worst piece of legislation that has ever been passed in my lifetime.”

Dr. Bentley can bark at the moon and tilt at windmills and even stand in a schoolhouse door, it really does not make any difference. Obama Care is coming to Alabama whether we like it or not. We are still a part of the United States and federal law prevails. The only difference between us and some other states is that the federal government will run our plan.

See you next week.