Healthcare Reform Passes, how much difference will it make immediately after being signed into law?

It is interesting that many of the same people who were yesterday telling us that if Obamacare passed, the sky would fall, the massive caldera that forms Yellowstone National Park would have its next super-eruption and cause a nuclear winter to kill all life in America and the Soviet flag would immediately be hoisted over the White House now are writing that nothing will change for years to come, it doesn’t do enough soon enough.

Why do you think they would change their tune so abruptly and discordantly? If, yesterday, it really was going the end all medical care and cause the Soviet Flag to be flown over the White House, how could it today be going to do nothing at all for years?