Changes from the Patient Protection and Affordable Care Act (ACA) are dominating the healthcare landscape. These changes under ACA are very important for people infected with hepatitis C virus (HCV). 2013 has seen increasing federal public health efforts aimed at diagnosing people with HCV. Baby boomers, the generation with the most HCV-infected people, has started to become eligible for Medicare. Further, new treatments for HCV are under development. Undiagnosed individuals and uninsured individuals may represent a population that payers and stakeholders have not yet experienced. This paper discusses how increased diagnosis, increased Medicare eligibility, and newly insured individuals with HCV will affect the U.S. healthcare system.