The Patient Protection and Affordable Act was signed into law in March 2010, but its two major expansions of health coverage don't begin until January 2014.
One expansion is the creation of healthcare exchanges. The exchanges offer a choice of certified health plans from which individuals and small businesses can choose. Government agencies and non-profit groups will organize and oversee a private market for buying health insurance. States are expected to established exchanges or create partnerships with the federal government. If states don't act, a federal exchange is supposed to serve those residents.
The other is the expansion of Medicaid (federal-state health insurance program for the poor and people with disabilities). For the first time in most states, adults earning up to 138% of the federal poverty rate, or $31,809 for a family of four, would be covered.
As passed and signed by President Obama, the law threatened states with the loss of all federal Medicaid funds if they did not expand their programs. The Supreme Court struck down that provision, freeing states to sidestep the expansion without losing other funds.
Source:
USA Today. Across the USA: Special Report on the Healthcare Law, p.5A. Friday, July 13, 2012.
