The Affordable Care Act (ACA) will impact employer-based insurance and union health plans. The impact will vary by employer and worker, depending on demographics and coverage. Unions should gather information about existing health plans and membership to make informed decisions in negotiations. Some unions may face a decision between bargaining for increased wages or health benefits. The decision will depend on the specific circumstances of each workplace, including members' family income, size, age, and current source of coverage. Unions may want to survey members prior to bargaining to understand their needs.