Home Find a Health Insurance Plan Find a Health Care Provider For Members For Employers For Health Care Providers
Helping Hands. Making a difference through community outreach.

Key provisions of health care reform through 2018

On March 22, the US House of Representatives approved the Senate version of the health care reform bill with a 219-to-212 vote, and the bill was signed into law by President Obama on March 23. A separate compromise package of changes was passed by the House and Senate and signed into law on March 30.

Here’s a PDF icon timeline following the law’s progress from bill creation into law.

For more information about how and when health care reform affects you, visit the Kaiser Foundation health care reform timeline.

Health care reform: What happens next?

Here is a look at some frequently asked questions about the new law.

The new health care law will change the health care system in America over the next decade. Here is a look at some of the major provisions in the legislation and when they would take effect.

Effective

What the legislation would do
2010
  • Require insurers to cover preventive screenings such as immunizations for children and cancer screenings for women.


  • Extend coverage to dependent children up to age 26 on their parents’ policies.


  • Give tax credits to businesses with no more than 25 employees and average wages of $40,000 to support coverage for their workers. The credit would be up to 35 percent of the employer’s contribution if the employer pays 50 percent of the total premium.


  • Introduce provisions to begin closing the doughnut hole for seniors in Medicare Part D, starting with a $250 rebate.


  • Prohibit insurers from rescinding coverage (except in cases of fraud), placing lifetime dollar limits on benefits, or excluding coverage for children with preexisting conditions.


  • Create $5 billion temporary high-risk insurance pool to provide coverage to individuals with preexisting conditions who have not had insurance for at least six months.
2011
  • Require insurers to provide rebates to customers if the insurers spend less than 85 percent of the premium dollar they collect on health care.


  • Freeze Medicare Advantage reimbursement rates at 2010 levels.


  • Begin assessing fees on pharmacy companies, estimated at $30 billion over 10 years.


  • Begin aggressive measures to fight fraud, waste, and abuse.


  • Launch national Medicare five-year patient-centered medical homes pilot.


  • Increase funding by $11 billion for community health centers.
2012 – 2013
  • Increase Medicare payroll tax by 0.9 percent on individuals making more than $200,000 and couples making more than $250,000. Unearned income, now exempt from the payroll tax, would also be subject to a 3.8 percent tax.


  • Begin assessing fees on makers of durable medical equipment, estimated at $20 billion over 10 years.


  • Impose limits of $2,500 on flexible spending account contributions for health expenses.
2014
  • Begin assessing fees on health insurers estimated at $70 billion over 10 years.


  • Mandate that everyone purchase insurance. Those who do not will pay an annual penalty, at $95 or 1 percent of income, whichever is greater.


  • Require employers who do not offer health benefits, or whose workers get coverage through an exchange, to pay a $2,000 penalty per employee.  Pertains to employers that have 50 workers and the first 30 employees are exempt from the penalty.


  • Offer federal subsidies to qualified Americans to offset the cost of insurance.


  • Begin insurance reforms that guarantee coverage and prohibit exclusions for preexisting conditions and annual dollar limits on coverage.


  • Begin state-based health exchanges.


  • Expand Medicaid to cover 15 million uninsured. From 2014 to 2016, the federal government will pay all of the costs for covering the newly eligible Medicaid beneficiaries.


  • Require plans to offer essential benefits for individuals and small groups.
2015
  • Raise penalties for not having insurance to $325 or 2 percent of income, whichever is greater.
2016
  • Raise penalties for not having insurance to $695 or 2.5 percent of income, whichever is greater.
2017 – 2018
  • Begin 40 percent excise or “Cadillac” tax on expensive health plans: $27,500 for a family plan and $10,200 for an individual plan.

Updated: April 15, 2010