In March 2010, President Obama signed The Patient Protection and Affordable Care Act (ACA), which included significant changes impacting health insurance coverage across the United States. Although many elements of the ACA were based on Massachusetts’ health insurance reform, there were still many decisions and activities that Massachusetts needed to address in order to comply with the new federal Medicaid and health insurance marketplace requirements, most of which were required to be effective as of January 2014. This issue brief, prepared by Health Management Associates, focuses on the changes in eligibility, benefits, cost sharing (including premiums), and health plan options available to individuals receiving subsidized insurance in the Commonwealth before and after implementation of the ACA.