Affordable Care Act Timeline
March 23, 2010: President Obama signs into law the Patient Protection and Affordable Care Act.
June 28, 2012: The U.S. Supreme Court upholds the constitutionality of the Patient Protection and Affordable Care Act.
Below is also a list of some of the key changes in the health insurance marketplace that affect consumers because of the Patient Protection and Affordable Care Act.
Provisions that became effective in:
- Appeals. Provides consumers with a way to appeal coverage determinations or claims to their carriers and establishes reviews of carrier denials by independent medical reviewers.
- Small businesses get tax credits helping them afford the cost of employee health insurance that they can provide to their workers. The credit is up to 35% of the employer's contribution to employees' health insurance. There is also up to a 25% credit for small nonprofit organizations.
- Medicaid programs providing coverage to previously uncovered low-income individuals and families may receive matching federal funds to help offset the cost.
- Pre-existing condition is the reason many people were denied coverage by a health insurer. Maryland residents with a pre-existing condition may be insured by Maryland's high-risk insurance program or the federal high-risk program. These programs will be in place until 2014 when insurance companies are banned from denying coverage to applicants based on a pre-existing condition.
- Children and young adults have increased access to health insurance. Children under 19 years of age may not be denied health insurance due to a pre-existing condition. Young adults without the option of receiving health insurance through their employer may stay on their parents' health insurance plan until the age of 26.
- Rescissions (cancellations) by insurance companies are no longer allowed for an unintentional error or technical mistake on your application form.
- Annual spending limits and lifetime spending limits controlled. Annual spending limits on new health insurance plans are restricted and lifetime spending limits may not be imposed on essential benefits.
- Reducing the cost of covering early retirees. Creates a new temporary re-insurance program to help companies that provide early retiree health benefits for individuals ages 55-65 to offset the expensive cost of that coverage.
- Preventive services. Requires coverage of certain preventive health services such as screening mammograms and colonoscopies without charging a deductible, co-payment or co-insurance.
- Reducing the Part D "Donut Hole" or coverage gap. Automatic 50% discount on brand-name drugs and 7% discount on generic drugs when beneficiaries fall into the coverage gap.
- Controlling premium cost increases is possible now because health insurance companies are required to spend 80% of the dollars collected for individual and small business insurance plans, and 85% of the dollars collected for large employer premiums, directly on health care services or health care quality improvement measures. This keeps insurance companies from needlessly raising premiums.
- Improving preventive health coverage for seniors. Provides a free, annual wellness visit and personalized prevention plan services for Medicare beneficiaries.
- Improving transitional care for Medicare beneficiaries. Establishes the Community Care Transitions Program to provide transition services to high-risk Medicare beneficiaries.
Provisions that are scheduled to take effect in:
- Hospitals will be held accountable for the quality of their services. Medicare Part A payments will be linked to the quality of care given based on standardized measures.
- Medicare funding will be enhanced by increasing the Medicare payroll tax for single individuals earning $200,000 or more and couples earning $250,000 or more.
- Medicaid preventive care services will be encouraged by providing new funding to states choosing to provide free or low-cost preventive care to their Medicaid recipients.
- Affordable insurance exchanges will begin operation. These are health insurance marketplaces created by the state. If your employer does not offer health insurance, you will be able to purchase affordable and qualified health insurance through these exchanges. Certain small businesses will also be able to purchase their health plans through the exchange.
- Tax credits to help the middle class afford health insurance will be available for individuals earning between 100% and 400% of the federal poverty line.
- Promoting individual responsibility. Requires most individuals to obtain acceptable health insurance coverage or pay a penalty. Penalties will not be applied if you have very low income and coverage is unavailable, or if you apply for a waiver.
- Annual limits on health insurance dollars spent will be totally eliminated.
- Denying insurance due to pre-existing conditions will be banned and insurance companies will not be able to refuse insurance coverage to anyone based on a pre-existing condition or charge higher rates to individuals based on gender or health status.
- Increasing access to Medicaid. Medicaid eligibility will increase to 133% of the federal poverty line for all non-elderly individuals to ensure that people obtain affordable health care in the most efficient and appropriate manner.
- Reducing overpayments in Medicare Advantage. Implement competitive bidding to eliminate overpayments to insurers in the Medicare Advantage program.
Health Education and Advocacy Unit
Consumer Protection Division
Maryland Attorney General's Office
410-528-1840 or 877-261-8807 (toll free)