Lisa Valera and her husband Manuel sign up for Obamacare at the Community Service Society Monday in New York. (AP Photo/Mark Lennihan)

April 1 (Bloomberg) — The first phase of Obamacare ended yesterday much the same way it began: The federal website drew millions of visitors and crashed at least twice.

As the Patient Protection and Affordable Care Act moves into a new stage today, when most consumers must be insured or pay a fine, an estimated 45 million Americans remain uncovered, a continuing burden for medical providers and governments, and a target for Republicans seeking to upend President Barack Obama’s signature initiative in the midterm election.

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