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Health Care Reform:

Health Insurance & Affordable Care Act

Health Reform Law Timeline

WebMD Feature

The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010. The law aims to expand insurance coverage to millions of Americans and puts in place consumer protections that did not previously exist. The ACA is scheduled to roll out over the course of four years, with its most significant changes to take effect in 2014.

Since the law’s enactment, 52 provisions have taken effect, and many more are in the works. Here, we highlight some of the law’s provisions, how they function, and when they take effect.

2010 Changes

Provision: Drug Rebates for Medicare

Effective: Jan. 1, 2010

Seniors and people with disabilities with Medicare who reached the prescription drug gap in coverage known as the “doughnut hole” received a rebate check of $250 to help pay for drug costs.

Impact: An estimated 4 million people received a rebate from the government in 2010.  

Provision: Small Business Tax Credits

Effective: Jan. 1, 2010

Small businesses with fewer than 25 employees and an average company salary of less than $50,000 that cover at least half of workers’ health insurance costs may qualify for a tax credit of up to 35% to offset the cost of premiums between 2010 and 2013. Nonprofit organizations are eligible for a 25% tax credit. Starting in 2014, credits increase to 50% (35% for nonprofits).   

Impact: An estimated 4.4 million businesses are eligible for the tax break. Yet, according to the IRS, as of mid-May 2011, only about 228,000 small business owners claimed the credit, for a total amount of more than $278 million.

Provision: States Expand Medicaid Early to Cover More People

Effective: April 1, 2010

States that expanded Medicaid eligibility for low-income individuals and families received matching funds from the federal government.

Impact: Seven states -- Connecticut, Colorado, Minnesota, Missouri, California, New Jersey, and Washington -- along with Washington, D.C., expanded Medicaid early under the Affordable Care Act. Nearly 600,000 people have been able to join the program since the law took effect.

Provision: Tax on Indoor Tanning

Effective: July 1, 2010

People who use indoor tanning services pay a 10% tax on its cost. The tax is collected by the business providing the services. First payments were due Nov. 1, 2010.

Impact: Although the Indoor Tanning Association estimated that 25,000 businesses were providing indoor tanning services, so far, only about 10,300 have filed tax forms reporting tanning taxes.   

Provision: Insurance for People With Pre-existing Medical Conditions

Effective: July 1, 2010

Pre-existing Condition Insurance Plans (PCIPs) make health insurance available to people with pre-existing medical conditions who have been uninsured for at least six months. The program is intended as a bridge between 2010 and 2014, when the Affordable Care Act makes it illegal for insurance companies to deny anyone coverage, regardless of their medical condition.

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