This issue brief from Health Access describes the impact of the Patient Protection and Affordable Care Act on Californians one year after its enactment. The brief describes how Californians have already benefited from the expansions in coverage for children, adults with pre-existing conditions, and seniors subject to the Medicare Part D “donut hole” gap in prescription drug coverage. The brief also describes the additional “early implementation” of some of the federal law here in California through the state’s Medicaid 1115 waiver. Finally, the brief contains useful appendices listing relevant state legislation enacted in 2010 and now pending in the current legislative session.