The open enrollment period for signing up for health insurance begins on Sunday, November 1 for the 2016 season. The Affordable Care Act has been under serious and constant attack since it was made law. This open enrollment period will be a litmus test to see if the health exchanges can bring more Americans healthcare coverage despite the fact that premiums keep on getting higher.

Millions are expected to sign up, reports The Wall Street Journal. The enrollment period ends on January 31, 2016. The current enrollment process is hoping to be smoother than the previous two tries which saw signup and software nightmares as well as a Supreme Court challenge. A recent survey taken by the Kaiser Foundation has found that less than 15 percent of all Americans even know open enrollment begins on Sunday. That is how weak the government’s attempts to advertise it has been.

Most Americans lament the high premiums and deductibles and many more say they simply can’t afford to buy health insurance. For many, it is a decision of whether to get health insurance or pay the rent and buy food. Health and Human Services Secretary Sylvia Burwell commented that she knows that they system has to get smarter and more efficient.

The outlook at Healthcare.gov on Sunday looks to be slow and barely measurable. Most people who have signed up over the years generally have waited until the last few days of open enrollment to do so. Also, beginning in 2016, the fine levied by the IRS for not having health insurance will be $695 per adult or two percent of your income.

In many parts of the country, premiums are expected to rise into the double digit percentage points. The second cheapest plan, the silver plan, is already noted to be 7.5 percent more expensive than it was last year. Many of the state exchanges are keying their open enrollment season to the federal schedule. The federal government hopes that at least ten million will sign up.