The federal health-care overhaul came with some big promises, for some great promise. A day before the election, where does the law stand, and how are health workers feeling?

The Affordable Care Act doesn't really work without presidential support. It requires a budget allocation and lots of bureaucracy to guide insurance companies and health exchanges.

President Barack Obama has said, elect him and it's full speed ahead. A Drexel University professor of health management and policy said he expects a lazier roll-out under a Romney administration.

"He could go slow on those, he could put a stop to them," Robert Field said. "So, the most likely thing he could do is just let things fall by the wayside and let the whole system not work as it's supposed to."

Former Massachusetts Gov. Mitt Romney, the GOP candidate for president, has talked about both a repeal and holding on to some of the new rules.

Many health law changes make doctors and hospitals more responsible and accountable for how patients fare.

In Philadelphia, Dr. Steven Sivak, chairman of medicine at the Einstein Healthcare Network, leads the medical center's physician corps. He said the health law is ushering in a new way of doing business and doctors are in the scrum. 

"We are stuck in the middle and we are challenged on how we can get from where we are to where we need to be," Sivak said. "So I think this is a very tumultuous time in the profession. Fast forward 10 years from now, I think things will be better. But I think the next 10 years will be very challenging."

The, nonprofit group, the Physicians Foundation surveys doctors across the country and keeps a close eye on the impacts of the Affordable Care Act.

Dr. Walker Ray, the foundation's vice president, said his colleagues were positive in the run-up to the legislation, but their outlook and attitudes have soured somewhat.

Doctors were expecting more relief, he says.

"... from malpractice and liability worries, from the regulatory environment, and some help from the physician shortage," Ray said. "A lot of things were not done in health reform that physicians were looking for."