WASHINGTON – Here are some of the major provisions of the
Patient Protection and Affordable Care Act, which is
projected to cost $938 billion over 10 years. The bill passed
the House March 21 and was signed into law March 23:
Changes in 2010:
– Insurance companies will be barred from discriminating
against children based on pre-existing conditions.
– Parents will be able to keep young-adult children on their
health insurance policies up to age 26.
– Senior citizens receiving Medicare will be eligible for
free preventive care, such as cancer screenings.
– People receiving Medicare Part D will receive an additional
$250 if the cost of their prescription medications reaches
the so-called “doughnut hole” coverage gap.
– New health plans must cover preventive care and checkups
for free. All plans will be subject to the requirement by
2018.
– Insurance companies will no longer be able to drop a
person’s coverage when he or she becomes sick.
– Indoor tanning services will be subject to a 10 percent tax
beginning July 1.
– A temporary federal program will allow companies to offer
health insurance coverage for early retirees between the ages
of 55 and 64.
– Employers, including nonprofit groups, with fewer than 25
employees will be eligible for government tax credits to
subsidize health insurance for their employees.
– Uninsured Americans with a pre-existing condition will be
able to purchase insurance in order to avoid medical
bankruptcy.
Changes in 2011:
– Flexible spending accounts will be limited to $2,500 a year
and over-the-counter medications not prescribed by a doctor
will no longer be eligible for reimbursement.
– Chain restaurants and vending machines will be required to
provide nutritional information for each item sold.
– Nonprofit hospitals will be required to perform a community
needs assessment and implementation plan every three years
and to widely publicize their financial assistance policies.
Changes in 2012:
– Medicare payments will be reduced for preventable hospital
readmissions.
– An Independence at Home demonstration project will be
created to allow high-need Medicare beneficiaries to receive
treatment while remaining in their homes.
– New annual fees will be imposed on the pharmaceutical
industry.
Changes in 2013:
– Payroll taxes will increase from 1.45 percent to 2.35
percent for individuals who make more than $200,000 and
married couples filing jointly who make more than $250,000.
Changes by 2014:
– All citizens and legal residents will be required to have
health insurance coverage or face a tax penalty, with certain
exemptions. Individuals and families making up to 400 percent
of the federal poverty level ($88,000 for a family of four in
2010) will be eligible for federal tax credits on a sliding
scale.
– Medicaid will be expanded to include children, pregnant
women, parents and adults under age 65 without dependent
children if they earn less than 133 percent of the federal
poverty level ($29,326 for a family of four in 2010). The
federal government will pay 100 percent of the costs of the
newly eligible in 2014 to 2016.
– Insurance companies will be barred from discriminating
against adults based on pre-existing conditions, health
status or gender.
– All employers will be required to offer health insurance to
their employees or face fines. Tax credits to companies and
nonprofit groups with 25 or fewer employees and average
annual salaries under $50,000 would cover up to 50 percent of
the insurance cost.
– Current federal funding levels for the State Children’s
Health Insurance Program will be extended through 2015.
– New annual fees will be imposed on the health insurance
sector.
– State-based insurance “exchanges” will be established that
will allow people under certain income levels to buy private
health insurance with government tax credits. Only citizens
and legal immigrants will be allowed to purchase insurance
through the exchanges.
– The Medicare program for senior citizens will move from a
fee-for-service reimbursement system for health care
providers to a more comprehensive, quality-based system.
– Insurance companies will be prohibited from placing annual
or lifetime caps on the dollar value of health coverage.
