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Do you know what extension he's on? nizagara opinion  There is no natural period of time within which one overhauls a health care system given a set of rules and regulations that constrain how the system can be built. But the legislation imposed one, because it had to; the program has to start somewhere. Remember, the 2014 start date for the exchanges was written into the law because it allowed the administration to build in certain complex assumptions about costs. Obamacare's alleged lack of revenue neutrality was, remember, a very big political weapon that opponents tried to use, but it failed because of the way the legislation was scored. The calendar for implementation was a key part of that score.