WASHINGTON - You've heard of the "fog of war." Well, now we've got the fog of Obamacare.
The controversial Affordable Care Act has so many moving parts that it's hard to know how its implementation is proceeding.
In 2014, many uninsured are supposed to get coverage either through exchanges, where they can buy subsidized policies if their incomes are less than four times the federal poverty line, or through an expanded Medicaid.
The trouble is that 20 or more states may reject the Medicaid expansion, and the exchanges aren't yet finished. Much is unknown.
It's not just that the Affordable Care Act's plumbing is still under construction. Millions of Americans are perplexed.
An April poll by the Kaiser Family Foundation found that one-fifth of respondents didn't think the act was still in force; they thought it had been repealed by Congress or struck down by the Supreme Court. About half the respondents didn't know how the law affects them personally.
President Obama recently called the confusion exaggerated. For the nearly 85 percent of Americans with insurance from large employers or Medicare and Medicaid (programs for the elderly and poor), there would be little change, Obama said.
That's probably true. But it leaves a sizable enclave of ignorance - mainly among workers for small and medium-size firms and the uninsured.
Under the Affordable Care Act, companies with more than 50 full-time workers are required to provide insurance or pay a fine (now called a tax) of $2,000 per employee (the first 30 are excluded from the tax).
Part-time workers, defined as those with fewer than 30 hours a week, aren't counted.
And uninsured individuals are required to buy insurance or face a tax penalty that begins at $95 in 2014 and increases to $695 in 2016.
How will these requirements work? Will smaller companies add insurance or drop it? Will uninsured individuals buy subsidized coverage in the exchanges or pay the tax?
To get some answers, I recently talked with the heads of four "professional employer organizations" - companies that act as "human resources" departments for small companies.
They provide payroll services and advise on fringe benefits and regulations. Their customers include construction companies, restaurants, small manufacturers and professional firms.
Many of these firms are only now coming to grips with the act, because they'd assumed that the Supreme Court would invalidate it or that a Republican White House would repeal it.
To encourage candor, we talked on a not-for-attribution basis. I left with three main takeaways:
* First, some companies now providing insurance are being hit with huge premium increases.