Millions of Americans will receive health insurance cover for the first time from 1 January as President Barack Obama's healthcare reforms come into effect.
The policy widely known as 'Obamacare' has been hugely controversial and the introduction of the new system has been beset with problems.
In a country where there is no state funded healthcare system Mr Obama's aim is to ensure all Americans have access to low cost medical insurance. Those who can't afford it will get help, but those who don't face a fine, the BBC reports.
The rollout has been troublesome. A government website set up to allow Americans to buy the insurance kept crashing on its launch in October last year. The president's approval ratings fell in the wake of the problems.
The White House says things have been fixed and that about 2 million people have enrolled so far. Some 50 million people currently do not have health insurance in the US.