In 2013 some 197 million Americans had commercial health insurance, through employers, individual purchases or policies with public subsidies. Now federal health reform adds to existing state regulation, mandates and consumer protections. ACA-authorized Health insurance Marketplaces or Exchanges led to just over 8 million individuals obtaining a new health policy between October 2013 and mid-April, 2014. The 2015 plan year adds more enrollees, but includes complexities of choices and potential penalties for some who choose to remain uninsured.
Large employers face a pending requirement to offer health insurance, while smaller employers can obtain an incentive subsidy if they opt to offer coverage. NCSL has extensive information describing current laws, pending bills and latest federal guidance and rules from HHS.