Connie Cass

WASHINGTON: The new year brings the big test of President Barack Obama’s beleaguered health care law: Will it work?

The heart of the law springs to life Wednesday, after nearly four years of political turmoil and three months of enrollment chaos. Patients will begin showing up at hospitals and pharmacies with insurance coverage bought through the nation’s new health-care marketplaces.

The course of 2014 will show whether Obama can get affordable care to millions of people in need without doing intolerable damage to the 85 percent of U.S. residents who already were insured.

Some dates to watch in 2014:

Wednesday: Coverage begins. Many low-income Americans who didn’t qualify for Medicaid in the past can use it now. People who signed up for private insurance in a state or federal marketplace by Dec. 24 (or later in some states) and have paid their first premium are now covered, too. Coverage also begins for workers at companies that have signed up for new small-business plans through the marketplaces, also called health care exchanges. Coverage lapses for people whose existing plans were canceled, if they haven’t signed up for a replacement or received an extension.

Jan. 10: Payment due. In most cases, marketplace customers who signed up by Dec. 24 have until now to pay the first month’s premium and get coverage for their January medical bills. Major national insurers agreed to accept payments 10 days into the month because of technical troubles plaguing online enrollment at HealthCare.gov.

Jan. 31: A temporary program for people denied coverage because of poor health ends. The Pre-Existing Condition Insurance Plan, originally set to expire Dec. 31, was extended one month to help sick people whose enrollment was stymied by HealthCare.gov computer crashes.

Late March: The patched-up health care website will face a major test if too many people rush to sign up in the final days of open enrollment.

March 31: Last chance for open enrollment through the federal marketplace or 14 states running their own exchanges. Late March enrollees will be covered beginning May 1. This is the deadline for most people to get coverage to avoid a fine.

April 15: Those who go without insurance won’t owe penalties until federal taxes are due in 2015 for the previous year’s income. Tax returns filed in 2015 will include health insurance information; insurers will send notices to confirm that taxpayers were covered in 2014. People who bought plans in the marketplaces and received either too little or too much in premium subsidies during the year also will square things with the IRS in April 2015.

Nov. 4: The midterm elections will be yet another referendum on the health-care law passed in March 2010 with no Republican support. Obama will still be in the midst of his final term, however. So even if Republicans emerge with control of both chambers of Congress, they will still face two more years with Obama in the White House to veto attempts to undermine his signature law.

Nov. 15: Open enrollment for 2015 begins. Americans can sign up for insurance or switch to a different plan. And they’ll see what rate increases are in store for the coming year.

Dec. 31: The extension ends today for people who were able to keep their old individual plans for an extra year, even though the coverage wasn’t up to the law’s minimum standards.