Objectives. To examine the public health and policy-relevant messages conveyed through local television news during the first stage of Affordable Care Act (ACA) implementation, when about 10 million Americans gained insurance. Methods. We conducted a content analysis of 1569 ACA-related local evening television news stories, obtained from sampling local news aired between October 1, 2013, and April 19, 2014. Coders systematically collected data using a coding instrument tracking major messages and information sources cited in the news. Results. Overall, only half of all ACA-related news coverage focused on health insurance products,whereastheremainderdiscussedpoliticaldisagreementsoverthelaw.Majorpolicy tools of the ACA-the Medicaid expansion and subsidies available-were cited in less than 10% of news stories. Number of enrollees (27%) and Web site glitches (33%) were more common features of coverage. Sources with a political affiliation were by far the most commonsourceofinformation(> 40%),whereasresearchwascitedinlessthan4%ofstories. Conclusions. The most common source of news for Americans provided little public health-relevant substance about the ACA during its early implementation, favoring political strategy in coverage.