In our first installment of our six-part series on the momentous reforms, NY1 health reporter Erin Billups takes a look at the impact of the gradual changes made in our healthcare system since the Affordable Care Act was signed into law in March 2010 and the fast approaching implementation of what's considered the focal point of the controversial reform laws.
The individual mandate, entrenched in controversy, was upheld last summer by the Supreme Court. It's the centerpiece of the Affordable Care Act that all Americans must have insurance starting January 2014.
Back in 2010, President Barack Obama said, "Affordable health care is not some privilege just for the few. It’s a basic right that everybody should be able to enjoy."
If you don't get insurance you will face a penalty: One percent of your income or $95, whichever is higher. The fee for kids is half that. And the penalty gets more expensive in 2016: 2.5 percent of your income or $695.
"Having everyone have health insurance coverage. Major first step," says Sara Collins of the Commonwealth Fund.
Collins says access to affordable care for everyone hinges on - in a large part - healthy folks buying in.
"Right now in New York people who are buying health insurance on their own tend to be a little sicker than average, tend to be a little older. See healthier people coming into the market, younger people which will lower everyone's premiums," explains Collins.
So there's a lot riding on the 2014 roll-out of the health exchange market places, and whether people actually sign up for care. Already there's been hiccups, some of which we'll touch on later in this series. But we have already seen some substantial changes to our healthcare system since 2010.
For 23-year-old Brian Reichter the Affordable Care Act means he can pursue his architecture career without worrying about healthcare coverage, because he plans to stay on his parents insurance.
"Probably until I'm either 26 or have a full time position," says Reichter.
Coverage is no longer denied for those with pre-existing conditions and there are no more lifetime limits on coverage. Also, insurers must spend 80 percent of every dollar you pay them on health care.
It's just the beginning of the fight to control health care costs.