Two new provisions of the controversial federal healthcare reform law went into effect on Wednesday.
One of them requires new and renewing health insurance plans to cover birth control for women at no out-of-pocket cost.
"I think it's a good thing if it's going to help everybody," Hazard resident Laura Combs said. Because we sure need help right now. Maybe that will cut down on the population of so many babies being born that nobody wants."
With this government mandate on birth control comes controversy.
"When you get into issues that are also life choice issues (such as) choosing to use birth control or choosing to have an abortion, things like that are also highly charged moral issues and religious issues, so there are going to be some fireworks," said Rev. Daryl Cornett, the pastor of First Baptist Church in Hazard.
There is also debate about whether private, faith-based institutions like some hospitals should be subject to the provisions.
"Whenever you have government stepping over the line and telling them what they must and must not do on issues that for them are issues that are a matter of conscience that intersect their belief system, then you've got a problem," Cornett said.
These potential problems are also casting uncertainty over the medical community.
"The care is going to be so controlled and so regulated and so restricted, people cannot have what they need," said Dr. Syamala Reddy, an opthalmologist. "They only care about what is available and what is approved."
The long-term effects have yet to be seen. But for now, women will be paying for birth control in their premiums instead of their pocketbooks.
The other part of the Affordable Care Act that went into effect Wednesday requires insurance companies to distribute more than one billion dollars in rebates to some individuals and companies. The rebates had to be paid by insurers who did not spend at least 80% of the premiums they'd charged for medical care.