The implementation of the Patient Protection and Affordable Care Act, the most significant addition to America’s social safety net in decades, is pushing ahead in Hawaii. However, even the most loyal supporter of "Obamacare" must be expecting a bumpy road as the bugs shake out of the system and millions of people adjust to an altered health-care landscape.

Remember the months following the launch of Medicare Part D, the drug-coverage benefit, in 2006? That was a bit rocky, too, and the scope of that change was far narrower than full-scale health care reform.

The new law, also called the ACA for short, has reeled out some of its more straight-forward and popular benefits since its enactment in 2010. Several went on the books in the first two years, among them: keeping adult children on parental plans until age 26; barring insurers from denying coverage to children with pre-existing conditions; closing the Medicare drug-coverage gap. A host of other changes, from new or increased taxes to changes in medical deductions and other programs, have taken effect.

But the planned Oct. 1 launch of the Hawaii Health Connector, along with online health-insurance exchanges being developed across the country, is the most high-profile change so far.

In the coming week or so, an announcement is anticipated about what plans will be open for enrollment as of Oct. 1. Enrolling Hawaii’s uninsured population — estimated at roughly 100,000 — is the principal goal of the ACA in Hawaii, because that will help lower the unreimbursed costs shouldered by health care providers state-wide. These are costs that have been passed on in the form of increased premiums, so it’s critical to get that percentage down.

An advertising campaign to get the word out has begun, which should help start priming the public for the changes ahead. But by itself, ads will never close the sale for very many people. The face-to-face approach is required, which is why the federal government has funded contracts for nonprofit groups to serve as "marketplace assisters."

In Hawaii, this program, dubbed "Hii Ola," will involve 34 community organizations. But time is ticking, and the process of signing final contracts with the groups hasn’t been finished.

Assuming that timetables are as hard as nails, this is worrisome. It’s going to take time for the groups to deploy staff to their community contacts and start the hard work of persuasion with people who, in large part, have been living without health insurance for years. People are not inclined to make such commitments while facing a short deadline.

So enough elasticity in the initial rollout is needed to ensure that these "marketplace assisters" have the time to do the job. The Obama administration is not yet talking about any extension in the individual mandate, maintaining a resolve about the Jan. 1, 2014, deadline for individuals to have insurance. This is probably a wise move to keep the pressure on the exchanges to step up preparations.

But about six weeks ago, officials from the IRS and the Government Accountability Office raised alarms about some states missing deadlines in the development of their exchanges. Preparations in Hawaii started earlier than in many states, but residents should anticipate some startup glitches.

Most of us don’t remember the early days of Medi-care, let alone Social Security, but those social programs took years to settle in, too.

In its most recent tracking poll, released in late August, the Kaiser Family Foundation reported that there are still popular misgivings and confusion about the law. About 37 percent of those polled said they have a favorable view of the law, and 42 percent an unfavorable view. However, a majority, 57 percent, said they disapprove of the notion of defunding Obamacare as a way to stop implementation.

The Republicans in Congress should take note of public opinion and abandon that scorched-earth campaign.

The ACA undoubtedly has its flaws, but rather than blocking the law, elected leaders should engage amending the parts that prove not to work.

By definition, reform is a continuing process. Obamacare, at its core, provides a sensible, market-based approach, bringing more of the population into the risk pool, including young people, to help shoulder the costs of health care and find ways to make systems more efficient.

It is the law of the land, and making it work should be the imperative. It’s time to get on with it.