The health care legislation being considered by the House of Representatives and the Senate have a rolling series of effective dates starting immediately upon passage of the legislation and running all the way into 2018. The following chart has been assembled to provide an overview on what becomes effective when.
Effective 2010
House provisions:
- Insurers must disclose new health premium rate increases.
- Individuals may maintain COBRA coverage until Health Exchange is in effect.
- Employers prohibited from reducing retiree health benefits for retirees, unless the same reduction is made to active employees' benefits.
- So called CLASS ACT is implemented in order to provide public long-term disability insurance, which would supplement Medicaid or private LTD benefits.
- Grants for employer wellness programs established.
Senate provisions:
- Plans must provide first dollar coverage for preventative care.
- Plans must annually report the share of premium dollars spent on health care and provide rebates to participants for excessive loss ratio (2010-2013).
- HHS Secretary to establish Web site through which residents of any state may find affordable coverage options in the state.
House and Senate provisions:
- Lifetime dollar limits for coverage prohibited.
- Temporary reinsurance assistance established for employers providing early retiree health benefits (ages 55-64).
Effective Jan. 1, 2011
House provisions:
- Low-income individuals to have more access to subsidies for Part D drug benefits.
- Cost-sharing for services in Medicare Advantage limited to that of traditional Medicare services.
- Health Benefits Advisory Committee to submit report on recommended essential benefits package to HHS Secretary.
Senate provisions:
- Employers must report the value of health care benefit provided on each employee W-2.
- Tax penalty increased to 20 percent for non-qualified expenses under health savings tax vehicles such as Health Savings Accounts.
- The amount of contribution to Flexible Spending Accounts limited to $2,500.
- Employer deductions eliminated for subsidies currently received for providing prescription drug plans for Medicare Part D retirees.
- Small business tax credit to begin for qualified employers purchasing health care for their employees.
- Simple Cafeteria Plans established and available for small businesses.
Effective Jan. 1, 2012
House provisions:
- Personal asset limits for Medicare Savings Program and Part D increased.
Effective Jan. 1, 2013
House provisions:
- All individuals required to obtain acceptable health care coverage or pay penalty of 2.5 percent of their income.
- Contribution amount to Flexible Spending Arrangement limited to $2,500.
- Employers required to offer health coverage to employees (and families) with minimum contributions and standards or pay an 8 percent payroll tax; employers with annual payrolls below $500,000 are exempt from the employer mandate.
- Small businesses that provide health coverage to employees are eligible for a tax credit up to 50 percent of the amount paid for coverage (credit lasts 2 years).
- Insurance companies prohibited from refusing to sell or renew policies on the basis of an individual's health.
- Exclusion of coverage because of pre-existing conditions is prohibited.
- Coverage through the Health Insurance Exchange provided to the uninsured and to employees of employers with 25 or fewer employees.
- Public health plan option established and is only available in the Health Insurance Exchange.
- Health Insurance Affordability Credits to purchase insurance in the Exchange provided to individuals with income above Medicaid eligibility and below 400 percent of poverty who are not offered acceptable health coverage.
- Access to Medicaid expanded to all individuals under 65 with incomes up to 150 percent of poverty.
Senate provisions:
- 40 percent excise tax imposed on so called "Cadillac health plans".
House and Senate provisions:
- Tax deduction for employers for the subsidy that they receive for continuing to provide a qualified retiree drug benefit is eliminated.
Effective Jan. 1, 2014
House provisions:
- Individuals offered employer-sponsored coverage may opt-in to the Health.Insurance Exchange if the employer's premium is equal to or greater than 12 percent of family income.
- Health Insurance Exchange expanded to include employers with 50 or fewer employees.
Senate provisions:
- Employers with 50 or more employees must offer health coverage to employees (and families) or pay an annual $750 penalty for each full-time employee.
- Employers with more than 200 employees must automatically enroll employees into employer-sponsored plans although employees may opt out.
- Employers with eligibility waiting periods over 60 days must pay $600 annually for each full-time employee subject to the waiting period.
- Health Insurance Exchanges created in each state.
- Insurance companies prohibited from refusing to sell or renew policies on the basis of an individual's health.
- Exclusion of coverage because of pre-existing conditions is prohibited.
Effective Jan. 1, 2015
House provisions:
- Health Insurance Exchange expanded to employers with 100 or fewer employees.
Effective Jan. 1, 2017
Senate provisions:
- States may permit businesses with more than 100 employees to purchase coverage in the Health Insurance Exchanges.
Effective Jan. 1, 2018
House provisions:
- Employer-sponsored plans must meet the acceptable coverage standards (grace period ends).
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