Health care reform: What happens next?
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
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.
Effective 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.
Effective 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.
Effective 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.
Effective 2015
*Raise penalties for not having insurance
to $325 or 2 percent of income, whichever is greater.
Effective 2016
*Raise penalties for not having insurance
to $695 or 2.5 percent of income, whichever is greater.
Effective 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
