In this Saturday, Dec. 12, 2015 photo, Zachary watches as his adoptive sister Mandie trims the Christmas tree at their home in Springfield, Mass. Zachary is a patient helped by a program funded by the Affordable Care Act, where his health care is overseen by a complex-care pediatrician and team of other medical specialists to optimize his care. Eric and Dennis Volz-Benoit say a strict routine is the key to raising their five special-needs children, including Zachary and Mandie. “It’s just kind of like a well-oiled machine,” said Eric. (AP Photo/Charles Krupa)

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