Here are some of the health care reform law’s provisions that have taken effect and are scheduled to begin since the bill was passed in 2010:



~  Health plans may not impose lifetime limits on the dollar value of essential benefits.

~  Annual dollar-value limits on benefits are restricted.

~  Insurers may not rescind (void) health insurance policies except in cases of fraud or intentional misrepresentation.

~  Adult children who are currently on their parent’s policies and unable to get insurance through their jobs may stay on their parents’ policies until age 26, regardless of their marital status.

~  Plans may no longer impose pre-existing condition exclusions on children under 19.

~  New policies must cover the full cost of preventative care.


~  Insurers must spend 80 percent of individual health insurance premiums on medical services or provide rebate payments to enrollees.


~  A new fee is imposed on health insurance companies to fund comparative effectiveness research.  $1 per participant through 2013;  $2 per participant through 2019.


~  Contributions to flexible spending accounts are limited to $2,500 per year.

~  Medicare payroll tax increases by 0.9 percent for individuals who make more than $200,000 and couples that make more than $250,000.

~  A new 3.8 percent tax will be added on income from interest, dividends, annuities, royalties, and rents for those at the same income threshold.


~  Health insurers must accept every individual who applies for coverage.

~  Health plans can no longer impose pre-existing condition exclusions for any person of any age.

~  No annual limits on health insurance benefits.

~  State health insurance exchanges introduced for individuals to buy insurance in certain states.  Otherwise, federal health insurance exchanges will apply.

~  Rating restrictions go into effect:  Insurance companies cannot charge women more than men, old people more than three times what young people pay, or smokers more than 1.5 times more than what non-smokers pay.

~  Essential benefit plan is created, which mandates the level of benefits that must be included in individual health insurance plans.

~  Families and individuals between 133 and 400 percent of the Federal Poverty Level get subsidies – on a sliding scale – to purchase insurance.

~  Medicaid program is expanded to cover everyone under 65 with an income less than 133 percent of the Federal Poverty level.

~  A non-deductible premium tax is imposed on insurers ($8 billion in 2014, rising to $14.3 billion in 2018, and increasing proportional to overall premium growth after that.)


~  States can form health choice compacts to allow insurers to sell individual policies in any state participating in the compact.



The Obama Administration announced that it would delay enforcement of the employer mandate under the Affordable Care Act (ACA) until 2015. The employer mandate requires employers with 50 or more full-time employees to offer health insurance to their employees or pay a penalty (shared responsibility). The employer mandate also imposes extensive reporting requirements on businesses.