1. Health Reform Timeline 2010 – 2020
2010 2011 2012 2013 2014 2018 2020
New Programs:
>
Temporary retiree reinsurance
program. Specific criteria applies;
limited funding.
Insurance Reforms:
New uniform coverage documents
and standard definitions are developed.
Hospitals, doctors and
payers encouraged to join
forces in “accountable care
organizations.”
Individuals making $200,000 a year
or couples making $250,000 would
have a higher Medicare payroll tax of
2.35% on earned income — up from
Coverage Mandates
Subsidies:
New Individual and employer
coverage responsibilities.
New tax (“Cadillac tax”) on
employer-sponsored health
plans that offer policies with
generous coverage levels.
Doughnut hole coverage gap
in Medicare prescription
benefit is fully phased out.
Seniors continue to pay the
Must have minimum medical loss ratios. the current 1.45%. A new 3.8%
National risk pool, small business tax on unearned income, such as
standard 25% of their drug
New Individual affordability
tax credit. Hospitals with high rates of dividends and interest, also added. tax credits and expanded small
costs until they reach the
Medicare Reforms:
preventable readmissions business tax credits. threshold for Medicare
$250 rebate for Medicare members
Start of Medicare Advantage
Contributions to flexible spending
facing reduced catastrophic coverage.
who reach the ”doughnut hole.” cost-sharing limits. accounts (FSAs) limited to $2,500 a
Medicare payments. year — indexed for inflation. And Health Insurance Exchange
Medicare beneficiaries who reach the threshold for deducting medical Insurance Reforms:
I
nsurance Reforms:
the doughnut hole to get a 50% expenses on taxes goes from
lifetime benefit limits —
No discount on brand name drugs 7.5% to 10% of income.
State individual and small group
based on dollar amounts. health insurance exchanges
Primary care doctors and general
Medical device manufacturers operational.
Allowed restricted yearly limits on surgeons practicing in underserved have a 2.9% sales tax on medical
the dollar value of certain benefits. areas, such as inner cities and rural devices; with exemptions for some,
Guaranteed issue, guaranteed
communities to get a 10% bonus. like eyeglasses, contact lenses renewability, modified community
coverage rescissions/
No rating and minimum benefit
cancellations (except for fraud
Medicare Advantage plans begin and hearing aids.
standards (“essential benefits” plan)
or intentional misrepresentation). having payments frozen. more deduction for expenses
No effective.
cost-sharing obligations
No allocable to Medicare Part D subsidy
for employers who maintain more lifetime and yearly dollar
No
for preventive services in network. Other: limits for essential benefits; no
prescription drug plans for their
Must have dependent
Yearly fee for brand-name Medicare Part D-eligible retirees. more restricted annual dollar limits
coverage up to age 26. drug manufacturers. for essential benefits.
Enhanced internal and external
Start of voluntary long-term care
New taxes on health insurers. ive
appeal processes. insurance program giving a cash ens lan
Exp lth p
benefit to help those with disabilities He
a
pre-existing condition
No
exclusions for dependent
stay in their homes or pay nursing “Cadillac tax”
home costs; benefit starts 5 years
children (under 19 years of age).
after paying coverage fee is imposed.
New health plan disclosure and
Increased funding for community
transparency requirements.
health centers to provide care Pre-existing condition
for many low-income and
uninsured people. exclusions are prohibited.
Individuals making $200,000 a 2014 Medicaid and
year or couples making $250,000 Medicare Reform:
Hospitals with high
have a higher Medicare
Medicaid expanded to cover
rates of preventable low-income individuals under
payroll tax.
readmissions face reduced age 65 up to 133% of the federal
poverty level—about $28,300
Medicare payments. for a family of four.
Employers are required to
Minimum medical loss ratio
of 85% required for Medicare
report the value of health Advantage plans.
care benefits on employees’
Dependent coverage W2 tax statements.
up to age 26 is mandated.
©2010 Aetna Inc.
00.03.978.1 (4/10)