Background: By March 2014, all U.S. citizens were required to have health insurance according to the Affordable Care Act (ACA). Purpose: Study objectives were to explore individuals' opinions, perceptions, and communication sources and needs about the ACA and to assess differences by age group. Methods: In November 2013, 10 1-hour focus groups (5 with adults aged 40+; 5 with adults < age 40) were conducted with 102 individuals in one southeastern county. Audio files were transcribed and organized using NVivo 10. Recurring themes were examined by age group. Results: Younger participants had less awareness of the ACA. Both older and younger groups mentioned benefits of receiving preventive care and being covered for preexisting conditions. Confusion and lack of perceived understanding were evident across age groups. Participants heard about the ACA mainly through media and few interpersonal sources. They preferred to obtain in-person ACA information through state officials or trusted experts. Discussion: Varying knowledge levels, perceptions, and communication sources about the ACA impact use of health insurance and access to care. Translation to Health Education Practice: Clear information should be communicated to each age group using their preferred communication channels to increase understanding of the ACA and its importance to prevent chronic diseases.