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What Is the Health Care Reform Timeline?


What Is the Health Care Reform Timeline?

(Credit: Jason Greenspan / Getty Images)

Question: What Is the Health Care Reform Timeline?
Answer: The Patient Protection and Affordable Care Act, also known as Obamacare, has created controversy since its inception. However, the biggest change is yet to come. Find out the future timeline, so you will be prepared. Follow the the twists and turns back through the different bills proposed by the House and Senate in 2009, ending at the beginning -- Obama's original campaign proposals in 2008.

2018 - Businesses who offer so-called "Cadillac" health insurance plans must pay a 40% excise tax on this benefit. These plans are defined as those with premiums of at least $10,200 (individuals) or $27,500 (families). They offer exceptional coverage, such as low copayments or unusual circumstances, such as marriage counseling. However, they also cover those with high health needs. For example, a business may have to offer Cadillac plans if the pooled risk of its employees are higher than usual, if many of them are sick, older, female or live in an area with expensive health costs. Cadillac plans are also required for those in dangerous jobs.(Source: Kaiser, Cadillac Tax Explained, March 18, 2010; Tax Impacts of Obamacare)

January 1, 2015 - Businesses with 50 workers or more will be taxed $2,000 per worker (except for the first 30) if they don’t offer health insurance. Those that do will receive a tax credit of 50% of the premium cost.

March 31, 2014 - Open enrollment for health insurance closes. Everyone must be covered, or be pay taxes as follows:

  • 1% of income in 2014
  • 2% of income in 2015
  • 2.5% of income in 2016
October 1, 2013 - Open enrollment for the health care exchanges begins. Medicaid benefits will be extended to those with incomes up to 133% of the Federal poverty level (for example, $31,321.50 for a family of four). Those with incomes up to 400% of the poverty level (for example, $94,200 for a family of four) receive subsidies. All plans must cover the 10 essential health benefits to be listed on the exchange. Find out How Much Will Obamacare Cost Me?

January 1, 2013 - Tax changes kicked in. For individuals, medical expenses must be at least 10% of income before they are deductible for those under 65. Those who make more than $200,000 ($250,000 for couples) will pay 3.8% Medicare taxes on dividends, capital gains, rent and royalties and 2.35% (up from 1.45%) Medicare taxes on income. For businesses, those who manufacture or import medical devices will pay a 2.3% tax.

States will benefit from additional Federal funds to offer free preventive services for Medicaid recipients, and extend CHIP for an additional two years. They'll also receive Federal funds to pay primary care physicians 100% of the Medicare fee. Medicare will launch a pilot program to help hospitals bundle services before they submit them for payment. (Source: Healthcare.gov)

June 28, 2012 - The Supreme Court upheld the legality of the Affordable Care Act. For more, see Obamacare Ruling

March 28, 2012 - The Supreme Court held hearings on the constitutionality of the Affordable Care Act. At issue was whether the Act's mandate that people either have insurance, or pay a fine, violates the Constitution. On Day Three, the justices considered whether the entire Act could stand if this statute was struck down. On Day Two, the justices questioned whether the Federal government had the right to compel people to buy health insurance from a private company. On Day One, the justices argued whether they had the authority to review the Act at this time, or needed to wait until someone paid the penalty in 2014.

September 2011 - The Justice Department petitioned the Supreme Court to decide whether the Affordable Care Act was constitutional. The 11th Circuit Court of Appeals found that the mandate did not fall within Congress' power to regulate interstate commerce, but that the rest of the Act was fine. Two other federal courts of appeal, the Sixth Circuit and the Fourth Circuit, ruled that the Act was constitutional.

January 2011 - The House voted to repeal the law. This was largely symbolic, since the Senate rejected the repeal. However, 22% of Americans thought the act had been repealed, anyway.

June 17, 2010 - Federal regulations allowed some health plans that were in existence on March 23, 2010 to be "grandfathered in." This meant they were exempt from the provisions in the Affordable Care Act.

March 23, 2010 - President Obama signed the Affordable Care Act, making health care reform the law of the land.

March 22, 2010 - The House of Representatives passed the Reconciliation Act, which amended the Senate Health Care Reform Bill by including elements of the health care plan put forth by President Obama on February 22.

February 22, 2010 - Obama launched a new health care plan that combined the best elements of the Senate and the 2009 House health care reform bills. Obama 2010 Health Care Reform proposal regulated the health insurance industry under a seven-member Health Insurance Rate Authority that could deny or limit substantial premium increases. This was traditionally a state responsibility. Like the Senate Bill, it created an exchange that allowed families and small businesses to shop for insurance plans. It kept restrictions on federal funding for abortion, but cut back taxes on the high end health plans.

January 28, 2010 - Obama supported health care reform in the 2010 State of the Union Address.

January 27, 2010 - House Democrats protested the excise tax on high value insurance plans in the Senate plan, which adversely affected union households. However, this created a $300 billion deficit over 10 years. The other option was to create a smaller health care reform bill with the best features of both the Senate and House plans.

January 26, 2010 - Republican Scott Brown won the key Democratic seat in Massachusetts, destroying the Democrats’ filibuster-proof 60-vote majority in the Senate. Many thought this ended hopes of passing any health care reform bill at all.

December 24, 2009 - The Senate passed the 2009 Senate Health Care Reform Bill. Its programs would cost $871 billion over 10 years. However, it would actually lower the budget deficit by $132 billion during that same time period by increasing taxes on health care providers. It offered subsidies to families and small businesses to shop for insurance on an exchange. It fined companies for not providing insurance, but gave them a tax break for small businesses if they simply couldn't afford to offer health insurance to their employees. For more details, see 2009 Senate Health Care Reform Bill.

November 8, 2009 - The House of Representatives passed the 2009 House Health Care Reform Bill. Its programs would cost $894 billion over 10 years. However, it proposed a surtax on high income earners thereby reducing the deficit by $104 billion. Like Obama's 2009 bill, the House bill proposed a government-run health insurance program, known as the public option. It offered direct subsidies to uninsured people to help them buy insurance through exchanges. For more details, see 2009 House Health Care Reform Bill.

January 2009 - Soon after Obama was elected, he announced the Health Care for America Plan. The most controversial element was known as the "public option," which was a government-run program like Medicare -- only it would not be restricted by age. This was a critical way to reduce health care costs by 1.5% per year, since the federal government had the ability to bargain for lower prices and reduce inefficiencies. However, opponents said it was socialized medicine, and took power away from the states and from individuals. For more detail, see Obama's 2009 Health Care Reform Plan. Article updated September 9, 2013

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