Americans have much to look forward to as the Affordable Care Act goes into full effect in January. But major legislation never passes without political compromise, ensuring that fixes and revisions will be required, just as has happened to Medicare, Medicaid and Social Security. President Barack Obama borrowed heavily from former Gov. Mitt Romney’s health reforms in Massachusetts and overlaid a new system atop the established private insurance market. That made the law far more complex and increased the likelihood that changes would have to be made. Now that it’s just months from full implementation, the following are among the tweaks needed to ensure more people get health coverage.