HCR Update from Mark Sanna: It's Oct. 1 and the Affordable Care Act is finally getting its rollout, but President Barack Obama's health-care law looks a lot different from the one he signed 31/2 years ago. Thanks to a Supreme Court ruling, about half the states aren't participating in a Medicaid expansion that was a core part of the legislation. The federal government is running the bulk of new marketplaces for health insurance, not the states as originally envisioned. And some of the key provisions are delayed, including one that makes larger businesses pay a fine if they don't offer coverage.