7. What is Obamacare Obamacare is the Patient Protection and Affordable Care Act of 2010. The Act was meant to reform health care, but it was stuck. The most important part of this Act requires you to have health insurance in 2014 or be subject to a tax. Coverage starts on January 1, 2014 if you've signed up by December 23, 2013. The Affordable Care Act contains over a thousand pages of reforms to the insurance industry and the health care industry in order to cut health care costs and to provide affordable health insurance to all Americans.