Implementation Timeline
The Affordable Care Act became law on March 23, 2010. Some of the law’s changes and new protections are already in place. Others will go into effect in the months and years ahead. Use our timeline to find out what the law means for you from now until 2014 and beyond.
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Insurer Requirements for Spending Your Health Care Dollar
Insurance companies are required to spend 85 cents of every health care dollar collected from large employers’ plans on health care services instead of administrative expenses and salaries. For small plans and plans sold to individuals, the requirement is 80 cents for every dollar. If insurance companies do not meet this requirement, they are required to give rebates to consumers.
Starting January 1, 2011
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Closing the Medicare Prescription Drug Coverage Gap
People in the Medicare Part D prescription drug coverage gap will receive a 50 percent discount on covered, name-brand prescription drugs and a 7 percent discount on generic prescription drugs. Savings on name-brand and generic drugs will continue over the next 10 years until the coverage gap is closed in 2020.
Starting January 1, 2011
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Provides Medicare Bonus Payments to Health Care Professionals
The law provides a 10 percent Medicare bonus payment for office visits to primary care physicians. It also provides a 10 percent bonus payment for office visits to general surgeons practicing in areas that are short on health professionals. This helps ensure that there are enough primary care professionals to take care of patients. And that general surgeons are available in rural and low-income communities.
Starting January 1, 2011 through December 31, 2015
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Preventive Services for Medicare
People in Medicare will receive certain preventive and screening services, such as mammograms and colonoscopies, at no cost to them. They will also receive an annual wellness visit with a health care professional.
Starting January 1, 2011
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Center for Medicare and Medicaid Innovation
The law creates a new Center for Medicare and Medicaid Innovation. The new center aims to improve quality of care and help lower costs by studying new ways of providing care.
Starting January 1, 2011
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Premiums for Higher-Income Medicare Part B Beneficiaries
The law freezes the income cap for income-related Medicare Part B premiums at 2010 levels ($85,000 per year for individuals and $170,000 per year for couples) until 2019.
Starting January 1, 2011
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Premiums for Higher-Income Medicare Part D Beneficiaries
Individuals in Medicare Part D making more than $85,000 per year, and couples in Medicare Part D making more than $170,000 per year, will begin paying a higher premium for Medicare Part D coverage.
Starting January 1, 2011
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Medicare Advantage Payment Changes
The law will gradually eliminate the extra payments to Medicare Advantage plans that result in higher premiums for people in Medicare. People who have a Medicare Advantage plan will still receive all guaranteed Medicare benefits, but some plans could reduce optional benefits. The law also provides bonus payments to Medicare Advantage plans that provide high quality care.
Starting January 1, 2011
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Medicaid Health Homes
The law gives states the option to let certain Medicaid enrollees choose a “health home” – a system of care that is centered around the patient and coordinates care to help meet the needs of people with chronic conditions. States that choose to offer the health home option will receive funds for two years to help cover the cost of providing home-related health services.
Starting January 1, 2011
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Chronic Disease Prevention in Medicaid
The law gives states grants to create programs that provide people in Medicaid with rewards for participating in certain lifestyle programs to help keep them healthy and prevent chronic diseases like diabetes and high blood pressure.
Starting January 1, 2011
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Improving Care for People in Medicare After They Leave the Hospital
The Community Care Transitions Program helps people in Medicare avoid returning to the hospital by connecting them with services like health coaches.
Starting January 1, 2011
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Changes to Flexible Spending Accounts (FSAs)
Flexible Spending Accounts and Health Reimbursement Accounts will no longer reimburse the cost of over-the-counter drugs not prescribed by a doctor. The law also ends tax-free reimbursements through a Health Savings Account or Archer Medical Savings Account.
Starting January 1, 2011
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Grants for Small Employer Wellness Programs
The law provides grants to small employers that establish wellness programs in the workplace.
Starting fiscal year 2011 (October 2010 – September 2011)
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Teaching Health Centers
The law funds programs to train primary care physicians in community-based clinics, called Teaching Health Centers.
Starting fiscal year 2011 (October 2010 – September 2011)
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Grants to Evaluate Ways to Reduce Malpractice Costs
The law authorizes $50 million for 5-year state grants to develop, implement and evaluate alternatives to current medical malpractice lawsuits and to improve patient safety.
Starting fiscal year 2011 (October 2010 – September 2011)
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Grants for American Health Benefit Exchanges
The law provides grants to states to start planning for the creation of state-based marketplaces called exchanges – where uninsured individuals and small businesses can shop for and buy health plans for themselves and their employees.
Starting March 23, 2011
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New Nutritional Labeling
The law requires that nutritional content be posted publicly for standard menu items at chain restaurants and food sold in vending machines.
Starting March 23, 2011
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Medicare Independent Payment Advisory Board
The law creates an Independent Payment Advisory Board that will make recommendations aimed at extending the Medicare Trust Fund and reducing the growth rate of Medicare spending if it exceeds projected growth rates. The Board’s recommendation is due on January 15, 2014.
Starting October 1, 2011
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Community First Choice Option through Medicaid
The law creates a new Community First Choice Option to allow states to offer home and community-based health services to disabled individuals on Medicaid as an alternative to institutional care in nursing homes.
Starting October 1, 2011