Health Care Reform Overhaul: What Happens When
Martha Lynn Craver
Various provisions of the new health care bill
The 2,400-page health care bill will gradually take effect over the next eight years, with many of the more popular provisions kicking in now, and more of the costs coming later. Here's a year-by-year rundown of what happens when:
--Provides tax credits to small employers with no more than 25 workers and average annual wages of less than
--Creates a temporary reinsurance program for employers that provide health insurance coverage to retirees over age 55 who are not eligible for
--Establishes a temporary national high-risk pool to provide health coverage to individuals with preexisting medical conditions. Effective within 90 days of enactment.
--Requires that all individual and group policies offer dependent coverage for children up to age 26.
--Prohibits individual and group health plans from placing lifetime limits on the dollar value of coverage; prior to 2014, plans may only impose annual limits on coverage as determined by the Secretary of
--Requires qualified health plans to provide, at a minimum, coverage without cost sharing for preventive services rated A or B by the
--Requires employers to disclose the value of health benefits on workers' W-2
--Provides free preventive services to
--Sharply cuts government payments to
--Provides a 10 percent
--Offers grants for up to five years to small employers that establish wellness programs.
--Creates a national, voluntary long-term care insurance program to help seniors buy services so they can continue to live in their community rather than a nursing home.
--Sets up a five-year demonstration program with grants to states to study alternatives to malpractice litigation.
--Requires chain restaurants and vending machines to disclose the nutritional content of each food item available for sale.
--Bars Health Savings Accounts, Flexible Spending Arrangements and Health Reimbursement Arrangements from reimbursing participants for over-the-counter drugs unless they have a prescription from their physician.
--Doubles (to 20 percent) the tax on distributions from an HSA that is not used for qualified medical expenses.
--Imposes an annual fee on drug companies based on market share. In 2013:
--Eliminates the deduction that employers now take for providing Medicare Part D Rx drug coverage to their retirees.
--Increases the threshold, from 7.5 percent to 10 percent of adjusted gross income, above which medical expenses can be itemized on Schedule A of the annual income tax form. Taxpayers age 65 and older will be exempt from this change through 2016.
--Limits contributions to an FSA for medical expenses to
--Raises the Medicare Part A (hospital insurance) tax rate on wages by 0.9 percent on earnings over
--Imposes an excise tax on the sale of medical devices, except for items purchased at the retail level by the public.
--Mandates that all U.S. citizens and legal residents have health insurance. There would be a phased-in tax penalty for those without coverage, starting at the greater of
--Mandates the start of operations for state-based Health Insurance Exchanges to serve as a marketplace in which individuals and small businesses can buy health insurance.
--Imposes fines on employers with 50 or more workers that do not offer coverage. The fine will equal
--Limits any waiting period for coverage to 90 days.
--Provides a refundable tax credit to help low-income folks buy coverage. To be eligible, a person's household income must be between 100 percent and 400 percent of the federal poverty level, generally around
--Allows employers to offer employees rewards of up to 30 percent of the cost of coverage (possibly increasing to 50 percent) for participating in a wellness program and meeting certain health related standards.
--Requires that health insurance companies start paying fees to the government based on market share.
--Imposes an excise tax on high-cost health plans, defined as those providing coverage in excess of
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Personal Finance - Health Care Reform Overhaul: What Happens When
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