2010

 

NEW CONSUMER PROTECTIONS
  • Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions. Insurance companies are prevented from denying coverage to children under the age of 19 due to a pre-existing condition. Effective for health plan years beginning on or after September 23, 2010 for new plans and existing group plans.  
 
  • Online Information for Consumers. The law provides for web-based platforms where consumers can compare different health insurance options and select the coverage that works best for them. 
 
  • Prohibiting Insurance Companies from Rescinding Coverage. In the past, insurance companies could search for an error on a customer’s application and take the policy back. The healthcare law makes this practice illegal. Effective on health plan years beginning on or after September 23, 2010. 
 
  • Eliminating Lifetime Limits on Insurance Coverage. Under the law, insurance companies will be prohibited from imposing lifetime benefit maxiums. Now, consumers cannot run out of essential benefits. Effective for health plan years on or after September 23, 2010.
 
  • Regulating Annual Limits on Insurance Coverage. Insurance companies will be limited on their use of annual dollar limits on the amount of coverage that a patient can receive for new plans in the individual market and all group plans. In 2014, the use of annual dollar limits on essential benefits will be banned completely for new plans in the individual market and all group plans. Effective for health plan years beginning on or after September 23, 2010.
 
  • Appealing Insurance Company Decisions. The law provides consumers with a way to appeal coverage determinations to their insurance company and established a new external review process. 
 
  • Establishing Consumer Assistance Programs in the States. States that apply can receive federal grants to help set up or expand independent offices to help consumers navigate the private health insurance system. These programs will help consumers file complaints and appeals; enroll in health coverage; and get educated about their rights and responsibilities in group health plans or individual health insurance policies. The programs will also collect data on the types of problems consumers have, and file reports with the U.S. Department of Health and Human Services to identify trouble spots that need further oversight. Grants Awarded October 2010. 
 
IMPROVING QUALITY AND LOWERING COSTS
 
  • Providing Small Business Health Insurance Tax Credits. Up to 4 million small businesses are eligible for tax credits to help them provide insurance benefits to their employees. The first phase of this provision provides a credit worth up to 35% of the employer’s contribution to the employees’ health insurance. Small non-profit organizations may receive up to a 25% credit. Effective immeadiately.
 
  • Offering Relief for 4 Million Seniors Who Hit the Medicare Prescription Drug “Donut Hole.” An estimated four million seniors reach the gap in Medicare prescription drug coverage known as the “donut hole” this year, where prescriptions are no longer covered for a period of time. Each eligible senior will receive a one-time rebate check for $250, tax-free. First checks were mailed in June, 2010.
 
  • Providing Free Preventive Care. All new plans must cover certain preventive services such as pap smears, mammograms and colonoscopies without charging a deductible, copay or coinsurance. Effective for health plan years beginning on or after September 23, 2010. 
 
  • Preventing Disease and Illness. A new $15 billion Prevention and Public Health Fund will invest in proven prevention and public health programs that can help keep Americans healthy. These programs will include issues like smoking to obesity. Funding began in 2010. 
 
  • Cracking Down on Health Care Fraud. New resources will be invested to stop fraud that require new screening procedures for health care providers to boost these efforts and reduce waste in Medicare, Medicaid and CHIP. Many provisions were effective immeadiately.
 
INCREASING ACCESS TO AFFORDABLE CARE
 
  • Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions. The PCIP, or Pre-Existing Condition Insurance Plan, provides coverage options to individuals who have been uninsured for at least six months because of a pre-exisiting condition. States have the option of implementing this program, and if they do not, a plan will be established by the Department of Health and Human Services in that state. National program effective July 1, 2010.
 
  • Extending Coverage for Young Adults. Young adults will be allowed to stay on their parents' health plan until they turn 26 years old. Effective for health plan years beginning on or after September 23.
 
  • Expanding Coverage for Early Retirees. Americans who retire without employer-sponsored insurance before they are eligible for Medicare often do not have access to health insurance on the individual market due to underwriting restrictions or high premiums. The new law creates a $5 billion program to provide needed financial help for employment-based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65, as well as their spouses and dependents. Applications for employers to participate in the program available June 1, 2010. Affordable coverage will be available for those individuals in 2014.
 
  • Rebuilding the Primary Care Workforce. Yhere are new incentives in the law to increase the number of primary care doctors, nurses and assistants - including scholarships and loan replayments for those working in underdeserved areas. Those receiving assistance will not have to pay tax on those payments. Effective 2010. 
 
  • Holding Insurance Companies Accountable for Unreasonable Rate Hikes. The law allows states that have, or plan to implement, measures that require insurance comapnies to justify their premium increases will be eligible for $250 million in new grants. If an insurance companies rates are unjustified, it will not be able to participate in the Exchanges in 2014. Grants awarded beginning in 2010.
 
  • Allowing States to Cover More People on Medicaid. States will be able to receive  federal matching funds for covering some additional low-income individuals and families under Medicaid for whom federal funds were not previously available. This will make it easier for states to cover more of their citizens. Effective April 1, 2010. 
 
  • Increasing Payments for Rural Health Care Providers. Rural communites have often had trouble attracting and maintaining medical professionals. The law provides increased payment to rural health care providers to help them continue to serve their communities. Effective 2010.
 
  • Strengthening Community Health Centers. The law includes new funding to support community health centers, allowing these centers to serve about 20 million new patients across the country. Effective 2010.

Affordable Care Act Timeline