With some changes to its financing structure, the Healthy Howard Health Plan could emerge as a viable option for Americans who will not be able to afford to buy insurance should the ACA be struck down. Initiated in October 2008, Healthy Howard provides comprehensive, affordable healthcare to working-class families and individuals who have incomes higher than the eligibility level for entitlement programs like Medicaid, but still too low to afford private health insurance. Based on the primary care "medical home" model, with an emphasis on wellness and preventive services, Healthy Howard uses a local, federally qualified health center as our primary care home.