The Patient Protection and Affordable Care Act (PPACA) is commonly referred to as the Affordable Care Act, Health Care Reform, or Obamacare. PPACA was signed into law on March 23, 2010. Effective January 1, 2014 , the law requires that all individuals have health insurance or be subject to a fine. The Employee Benefits and Services Division (EBSD) has developed this site to assist you in understanding how PPACA affects your enrollment in County-sponsored health plans. Review the areas below to find out more about the Affordable Care Act.