The Timeline for Key Affordable Care Act Provisions

Copyright © 2014 AARP. All rights reserved.

What does the Affordable Care Act (ACA) mean for your life and how do you navigate provisions that apply to you? As more people become aware of the ACA and realize that it’s changing the way healthcare functions in this country, it seems worth offering a quick overview of when key provisions were established and what additional measures will come into play in the future.

Here’s the rundown of how the ACA has played out so far and what you can expect going forward:

2010

Individual and small group health plans must cover more preventive care than they did previously. Health screenings and tests for certain cancers, diabetes, and heart disease are covered if they’re recommended for you.

Health plans can’t drop your coverage if you get sick.

Health plans cover children on your family plan up to age 26.

Health plans can’t put dollar limits on how much they’ll pay for covered benefits over your lifetime and must start phasing out annual dollar limits on your covered benefits.

Children up to age 19 can’t be turned down for health coverage because of a preexisting condition.

Small businesses with low-wage workers can qualify for a tax credit for up to 35 percent of their cost for health coverage.

2011

Medicare covers more preventive care health screenings and tests than it did previously.

The Medicare Part D prescription drug doughnut hole begins to close. The discount in 2011 is 50 percent for brand-name drugs and 7 percent for generic drugs.

Health plans have a limit on how much of premium revenue they can devote to profits and administrative costs compared to what they spend on patient care.

2012

The Medicare Part D prescription drug doughnut hole continues to close. The discount in 2012 is 50 percent for brand-name drugs and 14 percent for generic drugs.

2013

The Medicare Part D prescription drug doughnut hole continues to close. The discount in 2013 is 52.5 percent for brand-name drugs and 21 percent for generic drugs.

The Health Insurance Marketplace opens, allowing people to compare health plans, get questions answered, and enroll in plans for coverage that begin in 2014.

2014

The Medicare Part D prescription drug doughnut hole continues to close. The discount in 2014 is 52.5 percent for brand-name drugs and 28 percent for generic drugs.

Individuals, families, and small businesses have new ways to shop for coverage in the Health Insurance Marketplaces.

Financial help is available through the marketplaces to pay for coverage for low- and moderate-income families.

Health plans can’t charge you more based on your health history or gender.

Health plans must cover the costs of approved clinical trials.

States have the option to expand their Medicaid program to cover more people with limited incomes.

No one can be denied coverage just because of a preexisting condition.

Most people must get health coverage or pay a tax penalty.

The small business tax credit increases to cover up to 50 percent of the employer’s cost of coverage bought through the Health Insurance Marketplace.

2015

Larger businesses (employing the equivalent of 50 or more full-time people) must provide employee insurance coverage that meets established minimum standards or face paying penalties.

2015–2020

The Medicare Part D prescription drug discounts in the doughnut hole increase incrementally until it is effectively closed in 2020.

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