Regarding the recent proposed changes
At ChiroTouch, we have been working on implementing the new 2014 requirements for stage 1 and stage 2 for 8 months and were, in fact, one of very few software companies to get certified in time. To our knowledge, roughly 10% of software vendors are certified thus-far and there are only a few weeks left before the July 1 deadline.
Whether there is a delay or not, this engineering effort had to happen. If we knew of this delay earlier, we would have been postponing the scrambling to next year. Furthermore, the proposal calls for a 60-day review cycle so in a sense people that are attesting for the first time can't really wait. There is always the possibility that they wait and not start on time. If the proposal is declined, these doctors/hospitals would have to incur a penalty as they should, according to the rules, start operating under meaningful use measures no-later-than July 1. The government decision doesn't come out until the end of July.
The biggest risk for the government is that they wind up making this too complicated from an operational and technological perspective, at which point the whole stimulus program falls flat on its face. Clinical offices and hospitals run as businesses. At some point, the pain and cost of compliance outweighs the financial benefit and the program falls apart as a result of non-compliance.