Obamacare website 'embarrassing'
23 October 2013 Last updated at 10:47 BST
The Affordable Care Act, which is meant to lead to all Americans having health insurance, including the poor and those with pre-existing conditions, is President Obama's signature reform.
If it works President Obama will go down in history as the man who changed America but if not Obama's legacy will appear shaky at best.
Americans started signing up at the start of October but the website set up as an online clearing house for people looking for insurance has not been working properly.
From Washington, the BBC's Nick Bryant reports on the risk that if people do not sign up, the scheme will fall apart.
First broadcast on BBC Radio 4's Today programme on Wednesday 23 October 2013.