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Reform: A timeline

February 28, 2013
By JOSELYN KING - For The Times Leader , Times Leader

WHEELING - A majority of the changes being made to healthcare by the Affordable Care Act already are in place, with only a few remaining to be implemented over the next two years.

This year, the only initiative remaining is to provide additional federal funding for the Children's Health Insurance Program. In 2014, the following changes will be made:

New Health Law Provisions to be Implemented in 2014

The American Health Benefit Exchanges and Small Business Health Options Program (SHOP) begins Jan. 1, 2014. Individuals and small businesses with up to 100 employees will be able to purchase qualified coverage through the program.

Exchanges will have a single form for applying for health programs, including coverage through the exchanges and Medicaid and CHIP programs.

Individuals will be required to obtain basic health insurance coverage beginning Jan. 1, 2014, or pay a fee to help offset the costs of caring for uninsured Americans.

Employers with 50 or more employees who do not provide health care coverage will be assessed a fee of $2,000 per full-time employee - excluding the first 30 employees.

Americans who earn less than 133 percent of the poverty level (approximately $14,000 for an individual, and $29,000 for a family of four) will be eligible to enroll in Medicaid. States will receive 100 percent federal funding for the first three years to support this expanded coverage, phasing to 90 percent federal funding in subsequent years.

Tax credits to help the middle class afford insurance will become available for those with income between 100 percent and 400 percent of the poverty line who are not eligible for other affordable coverage.

Beginning in 2014, new health care law prohibits insurance companies from refusing to sell coverage to or renew the policy of an individual because of a pre-existing condition. It also eliminates the ability of insurance companies to charge higher rates due to gender or health status.

In 2015, the final change will be to improve health care quality and lower costs by "Paying Physicians Based on Value, Not Volume." According to the law, a new provision will tie physician payments to the quality of care they provide. Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care. This is effective Jan. 1, 2015.

Changes made to the healthcare system to date, according to, are as follows:

Changes in 2010

On March 23, 2010, President Obama signed the Affordable Care Act.

Putting Information for Consumers Online.

Prohibiting Denying Coverage of Children Based on Pre-Existing Conditions.

Prohibiting Insurance Companies from Rescinding Coverage.

Eliminating Lifetime Limits on Insurance Coverage.

Regulating Annual Limits on Insurance Coverage.

Appealing Insurance Company Decisions.

Establishing Consumer Assistance Programs.

Providing Small Business Health Insurance Tax Credits.

Offering Relief for 4 Million Seniors Who Hit the Medicare Prescription Drug "Donut Hole."

Providing Free Preventive Care.

Preventing Disease and Illness.

Cracking Down on Health Care Fraud.

Providing Access to Insurance for Uninsured Americans with Pre-Existing Conditions.

Extending Coverage for Young Adults.

Expanding Coverage for Early Retirees.

Rebuilding the Primary Care Workforce.

Holding Insurance Companies Accountable for Unreasonable Rate Hikes.

Allowing States to Cover More People on Medicaid.

Increasing Payments for Rural Health Care Providers.

Strengthening Community Health Centers.

Changes in 2011

Offering Prescription Drug Discounts.

Providing Free Preventive Care for Seniors.

Improving Health Care Quality and Efficiency.

Improving Care for Seniors After They Leave the Hospital.

Introducing New Innovations to Bring Down Costs.

Increasing Access to Services at Home and in the Community.

Bringing Down Health Care Premiums.

Addressing Overpayments to Big Insurance Companies and Strengthening Medicare Advantage.

Changes in 2012

Linking Payment to Quality Outcomes.

Encouraging Integrated Health Systems.

Reducing Paperwork and Administrative Costs.

Understanding and Fighting Health Disparities.

Providing New, Voluntary Options for Long-Term Care Insurance.

Changes in 2013

Improving Preventive Health Coverage.

Expanding Authority to Bundle Payments.

Increasing Medicaid Payments for Primary Care Doctors.



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