It’s a bit early to judge how effective these reforms will be when some of them haven’t even been implemented.
As with all laws, some aspects will be ineffective and others very effective.
Only time will tell.

I suspect that most likely victim of the recent Republican/Tea Party take over of the House, will be the insurance mandate. Carrot might work better than a stick. Perhaps a federal tax deduction for insurance premiums, vice a fine. Not that I’m a huge fan of more complexity in the tax code… it needs to be simpler… but that’s another discussion.