(EDITOR’S NOTE: Today the Sun-Gazette continues its annual look back on the major stories of the year in this series, 2013 Moments in the Sun.)

As far as some business people and lawmakers are concerned, the questions raised by the Affordable Care Act are many.

Problems with introducing the plan, including setting up the website that allows people to select coverage, have been well documented and have been part of the debate back and forth about what’s wrong with it.

Even President Barack Obama acknowledged that the government had fumbled the rollout of the health care plan.

Yet another stumbling block for many is that of keeping up with the seemingly ever-evolving aspects of the Affordable Care Act.

Williamsport/Lycoming Chamber of Commerce Executive Vice President Jason Fink said his organization began holding programs for companies and organizations about the plan back in March.

The hope was to prepare them for the new law.

“We thought it was important to get this information out,” he said.

But with changes occurring constantly, that has presented additional challenges for everyone.

One big change came in November when it was announced by the Obama administration that insurance companies now would have the option to offer consumers plans that would otherwise be canceled.

In the meantime, companies spent time and money to be in compliance with the Affordable Care Act, Fink noted.

The ever-evolving aspects of what has become known casually as “Obamacare” are particularly problematic to small employers.

“We are telling companies what we know as of this minute. That’s the challenge,” Fink said.

“No company wants to be out of compliance. It’s an additional burden on companies that don’t have a human resources manager who can explain this stuff.”

It’s the small companies, some say, that already are being more greatly affected by the new law.

“I think there are a lot of different things you have here,” said Jens Thorsen, a partner with the Hartman Group, a Williamsport insurance broker. “The rules change Jan. 1 in a number of different ways. If you are a large business with 50 or more employees, the rules change, but they are not terribly disruptive. For small employers … they are facing substantial disruptions.”

U.S. Rep. Glenn “GT” Thompson, R-Howard, said his office has heard from many people concerned about just how the Affordable Care Act will affect them.

He noted the most recent change giving insurers the option to continue offering the same coverage for another year.

“The president said you can keep your policy if you like it, but there is an if … if insurance companies allow it and state regulators approve it,” he said. “Insurance companies all know that they have to be in compliance within a year.”

Susquehanna Health officials said the recently revised provision to the Affordable Care Act has not been of great concern as far as coverage to its many employees.

“No, our plans have always been very robust,” said health system spokeswoman Tracie Witter. “Some other organizations’ health plans had exclusions – ours never did; therefore we’ve never had to improve our health plans because they were already at the required standard.”

Thompson said overall, he sees other problems such as rising costs.

He was in contact with at least one such business that will see its insurance costs increase some $20,000 per year.

At an individual level, the winners in “Obamacare” will be the high-income earners who can afford insurance and the poor who have been without coverage but will now receive it.

The middle class, he added, is absorbing many of the higher costs.

“The other thing people are worried about is physician access,” Thorsen said. “We just heard that a pretty substantial number of physicians were dropped from Medicare Advantage. One of the elephants in the room is how this plays out with some other things.”

In late November, UnitedHealthcare, described as the largest single health carrier in the nation, announced it was cutting its Medicare Advantage plans from physician contracts as of Feb. 1.

U.S. Rep. Thomas A. Marino, R-Cogan Station, is a big critic of the Affordable Care Act.

“This is such a mess,” he said. “There is something every day coming out. You can tell it’s a mess when you see Obama every day out campaigning that things will be all right.”

Marino said insurance companies are having problems rolling out plans to consumers because they don’t have all the information they need.

Insurance brokers locally, he said, are experiencing problems with enrollment, missing applications and other information.

And, there continues to be problems with the website, he noted.

“It’s still a long way from being fixed.”

Marino said he’s not optimistic that things will get better any time soon.

“On a daily basis, something comes up,” he said.

He’d like to see an alternative to the Affordable Care Act. Among provisions, it would:

Allow consumers to purchase insurance across state lines, thereby increasing competition.

Create an association of health care plans among small businesses.

Introduce tax reform to allow families to deduct their health care costs.

Bring about medical malpractice reform.