The author, a rehabilitation specialist, explains what he believes the Patient Protection and Affordable Care Act of 2010 (ACA) means for people with brain injuries. Aside from some confusion of reimbursement changes, the author believes that our most vulnerable citizens will see their circumstances fundamentally improve. Come 2014, medical underwriting is dead. Insurance rates will vary only by geography, smoking status, and a maximum of a 1 to 3 ratio between the youngest and oldest policy holders. Insurance plans must accept all customers regardless of pre-existing conditions, etc.