ObamaCare is in effect now. Some of the penalties for not having insurance are on hold until after the election, and the employer mandate is on hold until after the election, but ObamaCare is now the law of the land. There are a few court cases pending about the birth control mandate, but right now we are stuck with ObamaCare. So what does that mean?

For one thing, it means that confusion abounds. The U.K. Daily Mail reported on Friday that the staff in a hospital in Northern Virginia was turning away patients who couldn’t figure out whether or not they were covered by ObamaCare.

The article cites one example:

Patients in a close-in DC suburb who think they’ve signed up for new insurance plans are struggling to show their December enrollments are in force, and health care administrators aren’t taking their word for it.

In place of quick service and painless billing, these Virginians are now facing the threat of sticker-shock that comes with bills they can’t afford.

‘They had no idea if my insurance was active or not!’ a coughing Maria Galvez told MailOnline outside the Inova Healthplex facility in the town of Springfield.

She was leaving the building without getting a needed chest x-ray.

‘The people in there told me that since I didn’t have an insurance card, I would be billed for the whole cost of the x-ray,’ Galvez said, her young daughter in tow. ‘It’s not fair – you know, I signed up last week like I was supposed to.’

The x-ray’s cost, she was told, would likely be more than $500.

As she said, she did what she was supposed to, and now she can’t get the medical care she needs. The article points out that even if she had her medical insurance card, the Carefirst plan that Ms. Galvez signed up for has a $5,500 per-person deductible for 2014–that is the amount she would have to pay out-of-pocket before her coverage would apply to medical expenses.

The article concludes:

President Obama has attracted widespread criticism, and a ‘lie of the year’ award from one newspaper’s fact-checker, for promising that Americans who liked their health plans would be allowed to keep them.

Dr. John Venetos, a Chicago gastroenterologist, told the Associated Press on Thursday that he is seeing ‘tremendous uncertainty and anxiety’ among his patients who signed up for Obamacare plans but don’t have insurance cards.

‘They’re not sure if they have coverage,’ Venetos said. ‘It puts the heavy work on the physician.’

‘At some point, every practice is going to make a decision about how long can they continue to see these patients for free if they are not getting paid.’

We need to scrap ObamaCare and make a few changes to the previous healthcare system that would expand coverage for those who may not be able to afford it. We need to make insurance portable across state lines, we need to link insurance to the person–not the company he works for, we need tort reform. and we need tax subsidies to make sure low-income people can afford health insurance. What we don’t need is to mess up the insurance for the 90 percent of Americans who actually like their current healthcare plan.