Healthcare consumers and workers must speak up if some things don't work under the Affordable Care Act, the head of the Nevada State Medical Association said on Feb. 19.Larry Matheis, state medical association executive director, said the initial years of what many call Obamacare will turn out to be a period of experimentation.“It takes a while to know what's going to work,” he said of changes under the law. “We all have to live with them and make sure that we blow the whistle when they're not working.”Matheis spoke as part of a public forum put on at the Silver State Charter School Performing Arts Center. The event was sponsored by Sierra Nevada Forums, formerly Rising Above Partisanship.Dr. Susan Pintar, Carson City's Public Health Officer, moderated. A crowd estimated by organizers at a few more than 100 also heard from Dr. Sandra Koch and Debra Scott, Nevada State Board of Nursing executive director.Matheis indicated his prediction about experimentation was based on history, noting it took years before Medicare — a law that passed in the 1960s — emerged from its shakeout period.“I think it's going to take two years, three years, four years down the road,” he said of how ACA functions and gets altered.He asked how many knew if their existing health coverage had been “grandfathered” in and would continue. Then he said 80 percent will have the same plan in 2014.“You're not going to see any change,” Matheis said.But there will be changes because more will go on Medicaid and some will go into the Silver State Health Exchange program to get coverage.Each speaker talked of electronic medical records and other changes that will impact health care providers, thus changing the system over time.“It's an enormous undertaking,” Dr. Koch said of such record-keeping changes. She drew a laugh when she pointed out one benefit of computerized records: “They're actually legible.” She said, however, that it has cost millions and will require millions more over time. Scott, meanwhile, said nurses have been preparing for some time to cope with what is coming. She talked about electronic records and safety as well, but added nursing school enrollments in Nevada doubled about six years ago to be ready for the 280,000 more people who will need primary care in the state as changes phase in.