The implementation of the federal health care program popularly known as Obamacare will obviously affect the lives and finances of tens of millions of Americans.
Obviously, too, as the nation's largest state, California's implementation will play a major role in the program's success or failure.
But setting aside the human impacts for the moment, there are also heavy political effects, both nationally and in California.
President Barack Obama and his fellow Democrats are reeling from the bollixed-up rollout, especially in states that, unlike California, chose to have the federal government manage the enrollment process.
Not only has the system been plagued by chronic technical glitches, but Obama's personal standing has been seriously damaged by his repeated statements that those who are happy with their current health insurance could keep it.
At best, he misspoke, because many millions of individual policies are being cancelled for not meeting the new federal standards; at worst, he intentionally misled the nation to get his program through Congress.
In seeming desperation, Obama sought to protect himself and his party from fallout during next year's elections by delaying some enrollment deadlines and calling on state insurance regulators to allow old policies to remain temporarily in force or be reissued.
But Covered California, the state's new health care exchange, refused last week to go along with the plea, forcing upwards of a million Californians facing cancellation to quickly buy new, often more costly coverage.
California's vulnerable congressional Democrats cringed, because it gives their challengers heavy ammunition. Their rivals can roll out stories of constituents who are being compelled to buy more expensive health policies against their will.
Covered California's refusal to extend policies also adversely affects state Insurance Commissioner Dave Jones' hopes of persuading voters next year to give him broader power to regulate health insurance rates.
Another agency, the Department of Managed Health Care, oversees the vast majority of health policies now, and its rivalry with Jones has been palpable -- one that he hoped to win with a 2014 ballot measure in partnership with Consumer Watchdog, a frequent "intervenor" in insurance cases pending before Jones' department.
Jones had seized upon the cancelled policy issue to boost his plea for more authority and persuaded a couple of insurers to briefly extend some policies. Had Covered California backed Obama, the issue would have re-emerged late next year, providing fuel for Jones' November measure.
That may have not been the only reason Jones and Consumer Watchdog criticized Covered California as anti-consumer, but from a political standpoint, it was a setback. And Jones' shrinking role in health insurance could wither even further.