Lucy Castro never had health insurance for her 10-month-old son or her 7-year-old daughter until Thursday. She hesitated to take them to get medical care, knowing she could ill afford it.
"One time I took her to the doctor because she had flu symptoms and I had to pay like $300," she said of her daughter.
As new health care rules took effect, Castro signed up the kids for a state-funded plan through Kaiser Permanente. But their new coverage highlights one way insurance companies are responding to health care reform.
The new rules guarantee coverage for children 18 and under who have pre-existing conditions. As a result, many insurance companies are opting not to sell child-only insurance plans.
Castro signed up for Kaiser because Healthy Kids is no longer offering the policies.
Under the new rules, parents are also allowed to keep kids on their policies until the age of 26.
For Nora Salazar, that means her 22-year-old son is safely covered, even though his job doesn't offer him health benefits.
"After today, he will be on my health insurance," she said. "He will have somewhere to go when he gets sick. He won't have to wait until it's an emergency and he has to go to the hospital."
The health care reform package also tries to address a growing problem for the Central Valley.
The federal government will now pay off some loans for primary care doctors who work in underserved areas -- like the Valley, where there are 31% fewer primary care physicians than in the rest of the state.
"Which will lead to reduced heart disease, reduced cancer rates," said Fresno County Health Director, Dr. Ed Moreno. "They'll be able to work in the community and try to reduce rates of diabetes which is really important to reducing health care costs in the United States."
The new rules also force insurance companies to pay the entire cost of preventive care, such as pap smears, mammograms, prostate exams and annual checkups.
Another set of changes goes into effect in January, including more incentives for doctors working in shortage areas, like the Central Valley.