After rancorous debate, a Supreme Court case, and enrollment glitches, US President Barack Obama's signature legislation, the Affordable Care Act, also known as Obamacare, has finally gone into effect.
There are people out there who are literally dying because they don't have care.
But the president's plan of offering affordable healthcare to most Americans has an unintended gap in it.
While the Supreme Court upheld the law as constitutional, it allowed states to decide whether to expand their Medicaid programmes to more of their poorest residents.
Now more than five million Americans - mostly indigent and working poor - have been left without access to healthcare coverage because almost half the states have opted out of Medicaid expansion.
Fault Lines travels to Florida, Texas and North Carolina to examine a new dichotomy in US healthcare: how some of the country's poorest communities are being left behind while elsewhere millions of others in the same demographic have access to life-saving care.