What Obama's Health Care Law Does A brief summary of the 900-page plus Affordable Care Act, unless noted provisions take effect in 2014: Provides coverage to more than 30 million uninsured. Expands Medicaid to cover more uninsured low-income people. Creates exchanges, state-based health insurance markets, for small businesses and people buying private coverage individually. Provides government subsidies for many middle-class people buying private health insurance through an exchange. Allows young adults to stay on parents' coverage until age 26. Already in effect. Requires health plans to cover preventive care without charging co-pays. Requires most citizens and legal residents to carry health insurance, either through an employer, a government program or by buying a policy directly. IRS will assess fines for noncompliance. Requires companies with 50 or more workers to provide coverage, or pay fines if any of their employees ends up getting a health insurance subsidy. Raises taxes on upper-income households; imposes a variety of taxes and fees on the health care industry. Places a 10 percent sales tax on indoor tanning. Some taxes already in effect. Cuts Medicare payments to hospitals, insurers and other service providers; improves preventive benefits for Medicare recipients and gradually closes prescription drug coverage gap. Limits future increases in Medicare spending. Some Medicare provisions already in effect. Significantly increases federal regulation of the health insurance industry. Congressional Budget Office estimates coverage expansion will have a net cost of $1.1 trillion from 2012-2021. Spending cuts and tax increases are currently projected to offset the cost, for a modest reduction in federal budget deficits. Source: Associated Press research.