Health Care Reform:

Health Reform Law Timeline

2010 Changes continued...

States can choose to run the program on their own or let the Department of Health and Human Services establish one on their behalf.

Impact: Today, 27 states operate their own PCIP program. Twenty-three states and the District of Columbia have opted for the federal government to operate the program for them.

To date, the program has extended insurance coverage to 62,000 Americans, a number that falls far short of the government’s initial prediction that 375,000 people would enroll by the end of 2010.

Provision: New Consumer Web Site

Effective: July 1, 2010

The Department of Health and Human Services developed an online web site where consumers can search for health insurance coverage options in their state. The Insurance Finder resource on Healthcare.gov has information about both public and private insurance, including a summary of costs and coverage details.

Impact: The site offers information about 4,000 private health plans offered by more than 200 insurers throughout the country.

Provision: Right to Appeal Insurer’s Decision

Effective: Sept. 23, 2010

Consumers can now file two different types of appeals if they disagree with a decision made by their insurer.

First, consumers can file an internal appeal with their insurer. Second, consumers can appeal their insurer’s decision to an independent third-party if they are not happy with the outcome of the internal appeal.

Plans with “grandfathered” status -- those that were already in place when health reform became law on March 23, 2010, and have made minimal changes to their benefit designs and costs -- are exempt.

Impact: By 2013, only 34% of small businesses with 100 or fewer employees offering health plans and 55% of large employers are expected to have grandfathered status. On the individual market, between 33% and 60% of health plans are expected to lose their grandfathered status by 2013.

Provision: Young Adults Gain New Coverage Options

Effective: Sept. 23, 2010

Young adults are allowed to stay on their parent’s health insurance plan until they turn 26 years old as long as they do not have access to insurance of their own through a job. Even adult children who are married or live in another state may be eligible.

Impact: To date, 6.6 million young adults have been able to sign up for coverage on their parents' plans, including 3.1 million who would have been uninsured without the law. 

Provision: Children With Pre-existing Conditions Guaranteed Coverage

Effective: Sept. 23, 2010

Health plans can no longer deny insurance coverage to children under the age of 19 with pre-existing health conditions. This applies to new and grandfathered plans in the employee-based insurance market but does not apply to people with existing plans purchased on the individual insurance market.