Last-minute shoppers are getting an extra day. Not for buying Christmas gifts, but for purchasing health insurance.

Americans wanting to buy insurance through the HealthCare.gov website can do so through just before midnight on Christmas Eve and still get a Jan. 1 effective date. The White House quietly implemented the latest delay -- one of many over the last several months. Why the holiday surprise?

Healthcaregov Updated

Source: HealthCare.gov

Forward thinking

When asked about the extra day, Centers for Medicare and Medicaid Services, or CMS, spokesperson Julie Bataille said that the official deadline for obtaining a Jan. 1 effective date for health insurance was still Dec. 23. However, Bataille noted that actions were taken to allow selection of plans on HealthCare.gov through the following day because the agency anticipated "high demand and the fact that consumers may be enrolling from multiple time zones".

Hmmm... How far in advance would someone have been able to predict that demand for signing up might pick up right before the deadline? You'd also think that somewhere within the vast resources of the federal government that at least one person might realize early on that there are multiple time zones in the U.S. And yet, according to The Washington Post, the Obamacare website was changed over the weekend to accommodate the delay. 

There could be another factor behind the last-minute decision. The enrollment period for the earliest effective date is now a day longer probably in large part because the enrollment numbers themselves are well short of projections. Back in September, Health and Human Services, or HHS, projected that 3.3 million Americans would be enrolled in health insurance plans by the end of the year. As of this weekend, the actual number was around 2.3 million below that goal.

Hope and hurdles

A mad dash to sign up by many individuals could make up at least part of the big gap. Federal officials are hoping so -- and they're also counting on the latest website change helping to handle a late surge. Several hurdles remain, though.

While the federal website appears to be in much better shape than it was just weeks ago, some problems persist. A potentially bigger issue, though, is whether the back-end systems will work as they should. As of the latter part of November, as much as 40% of those systems remained undeveloped.

Health insurers are reeling from the flurry of changes coming from the federal government over the past few weeks. Aetna (NYSE:AET) was just one major insurance company that decided it couldn't comply with the White House decision that canceled policies that didn't meet Obamacare's minimum benefits requirements could be reinstated. It remains to be seen how Aetna and others will be able to handle the most recent change. 

The next shoe to drop?

With changes and delays for Obamacare becoming something of a routine, the obvious question is what will be the next shoe to drop? One item possibly high on the list could really wreak havoc: a full delay of the individual mandate.

That mandate has already been pushed back for Americans whose policies were canceled. Sen. Joe Manchin, D-West Virginia, and Sen. Mark Kirk, R-Illinois, are proposing that all individuals get the same treatment by delaying the individual mandate for a year.

If this legislation gains traction and ultimately passes, expect a collective groan from the hospital industry. While hospital stocks have experienced tremendous gains over the last year in anticipation of the benefits from Obamacare, the chaos with the implementation process seems to have taken its toll on some major players.

Shares of Tenet Healthcare (NYSE:THC), for example, have dropped 20% since early November. Community Health Systems' (NYSE:CYH) stock fell 13% during the same period. Even with these pullbacks, both stocks have roughly doubled over the past two years.

A delay in the individual mandate certainly isn't beyond the realm of possibility. What would be the biggest Obamacare surprise of all that could happen in the days ahead, though? That's a tough one, but here's perhaps the best answer: no more surprises.

Don't be surprised by how Obamacare impacts you

Fool contributor Keith Speights has no position in any stocks mentioned. The Motley Fool has no position in any of the stocks mentioned. Try any of our Foolish newsletter services free for 30 days. We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. The Motley Fool has a disclosure policy.