On March 23rd, 2010 President Obama signed into law the Health Care Reform bill, the Patient Protection and Affordable Care Act (PPACA). Many of the items of the law have been put into place; dependent children coverage to age 26, no pre-existing conditions for children under age 19, no dollar limits on benefits, expansion of preventative services, but several other items, including the establishment of medical exchanges will be in the forefront this year.