First, this is the first day of fundamental reform of the business and regulation of health insurance in all 50 states:Banning the practice of "medical underwriting" by which insurance companies rate enrollees based on their health status and medical history, Banning pre-existing condition exclusions from US health insurance everywhere, Establishing "guaranteed issue" as the new operating paradigm for individual health insurance, Completely eliminating lifetime limits on all health insurance, and Establishing "minimum essential benefits" that must be included in nearly all licensed health insurance policies everywhere.
Second, Medicaid coverage begins for close to five million uninsured low-income Americans in participating states, with many more millions to follow. This will happen more slowly than the Affordable Care Act's designers expected because of the Supreme Court ruling that made the Medicaid expansions optional for states. But come they will.
Third, private health insurance coverage starts for about one million Americans purchasing coverage through the federal/state health insurance marketplaces with many more to follow.
Fourth, the principle of personal responsibility -- aka the "individual mandate" -- to obtain health insurance coverage takes effect, with the Supreme Court's stamp of approval.
From Boston.com by same author