Even as President Obama prepares to acknowledge the six-month mark since he signed his health-care overhaul into law, the legislation remains something of a mystery for patients and politicians alike. Its impact is instead being felt largely by state workers nationwide whose job is to implement the law - and thus begin the mammoth task of transforming the care Americans receive.

For legions of men and women such as James Focht, who coordinates health information technology for the District, that means longer hours and extra work.

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