AUDIE CORNISH, HOST: From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish. Happy new year. Today marks the first day that millions of Americans will be covered by insurance under the Affordable Care Act. In a moment, we'll get the latest on the debate around one requirement of the law that most employers provide contraceptive coverage.</s>AUDIE CORNISH, HOST: But first, some big change went into effect today. To run through them, here's reporter Sarah Varney.</s>SARAH VARNEY, BYLINE: It's a crisp sunny day outside the entrance to the emergency department at Alta Bates Medical Center in Oakland California. A few visitors carry flowers through the sliding glass doors, but otherwise the E.R. is remarkably quiet. The stillness belies the profound changes the U.S. healthcare system underwent as revelers rang in 2014.</s>SARAH VARNEY, BYLINE: Starting today, there are new rules for insurance companies. They can't deny coverage based on a person's medical history and they can't charge women more than men. The companies can't set a limit in medical expenses and they must cover basic services. Also starting today, the federal government will subsidize private insurance for millions of low and middle income Americans and open up Medicaid in the 26 states that chose to do so to all poor residents.</s>SARAH VARNEY, BYLINE: For NPR News, I'm Sarah Varney in Oakland.
New rules from the Affordable Care Act go into effect Wednesday, and coverage starts for millions of Americans who signed up for health insurance on state and federal exchanges.