With the ending of the operational first year of the American Affordable Care Act, health insurance premiums were accessed online. For a US$50,000 income, the lowest premiums ranged from US$805 annually (age 20 years) to US$3802 (age 64 years), while the highest ranged from US$2186 (age 20 years) to US$10,326 (age 64 years). The lowest premiums at age 50 years were higher in rural areas in contrast to the highest premiums that were less expensive rurally. At age 64 years, the lowest premiums were 9-12.6% of a US$50,000 income, while the most expensive varied between 16.5 and 39%. Access to gynecologic oncologists was variable in different networks. Medicaid enrollment nationally was ∼6× higher than paid enrollment. Eligible participation in Affordable Care Act coverage exceeded expectations by >190%. Performance of four healthcare exchange traded funds indicated that investor confidence is high in the American healthcare sector.