Complete the Health Care Timeline worksheet. In this worksheet, you will create a timeline and describe the evolution of the United States health care industry.
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HealthReformImplementationTimelineKFF.pdf
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Health Reform Implementation Timeline Published: Jul 08, 2013
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PrintThe implementation timeline is an interactive tool designed to explain how and when the provisions of the Affordable Care Act will be implemented over the next several years. You can show or hide all the changes occurring in a year by clicking on that year. Click on a provision to get more information about it. Customize the timeline by checking and unchecking specific topics.
CUSTOMIZE BY TOPIC PROVISION BY YEAR
2010 (26 IN TOTAL, 26 IN EFFECT) +
2011 (20 IN TOTAL, 18 IN EFFECT) +
2012 (11 IN TOTAL, 10 IN EFFECT) +
State Notification Regarding Exchanges
Medicare Bundled Payment Pilot Program
Medicaid Coverage of Preventive Services
Medicaid Payments for Primary Care
Itemized Deductions for Medical Expenses
Flexible Spending Account Limits
Medicare Tax Increase
Employer Retiree Coverage Subsidy
Tax on Medical Devices
Financial Disclosure
CO-OP Health Insurance Plans
Extension of CHIP
Medicare Disproportionate Share Hospital Payments
Medicaid Disproportionate Share Hospital Payments
2013 (14 IN TOTAL, 13 IN EFFECT) ,
States indicate to the Secretary of HHS whether they will operate an American Health Benefit Exchange.
Implementation: January 1, 2013
Implementation update: On May 16, 2012, HHS issued a Blueprint that states must submit to HHS by November 16, 2012 if they wish to operate a state-based exchange or a Partnership exchange. On November 15, 2012, the Obama administration extended the deadline for submitting a state-based exchange blueprint to December 14, 2012 and set February 15, 2013 as the deadline for submitting a blueprint to participate in a partnership exchange. Seventeen states and DC notified HHS that they planned to run a state-based exchange and another seven states indicated they will run a partnership exchange
Learn more: Where are states in establishing and implementing their health insurance exchanges? Track state actions with our Exchange Monitor.
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Increases Medicaid payments for primary care services provided by primary care doctors to 100% of the Medicare payment rate for 2013 and 2014 (financed with 100% federal funding).
Implementation: January 1, 2013 through December 31. 2014
Implementation Update: On May 9, 2012, CMS issued a proposed rule for this provision. According to a CMS release, states are expected to receive more than $11 billion in new funds for their Medicaid primary care systems. On November 6, 2012, CMS published a final rule explaining the increase in Medicaid payment for primary care services by certain physicians in 2013 and 2014. CMS also released a set of Q&A’s on the primary care payment increase.
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Limits the amount of contributions to a flexible spending account for medical expenses to $2,500 per year, increased annually by the cost of living adjustment.
Implementation: January 1, 2013
Implementation update: On June 25, 2012, the IRS issued guidance limiting contributions to health flexible spending arrangements at $2,500 for plans beginning in 2013.
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Expanded Medicaid Coverage
Presumptive Eligibility for Medicaid
Individual Requirement to Have Insurance
Health Insurance Exchanges
Health Insurance Premium and Cost Sharing Subsidies
Guaranteed Availability of Insurance
No Annual Limits on Coverage
Essential Health Benefits
Multi-State Health Plans
Temporary Reinsurance Program for Health Plans
Basic Health Plan
Employer Requirements
Medicare Advantage Plan Loss Ratios
Wellness Programs in Insurance
Fees on Health Insurance Sector
Medicare Payments for Hospital-Acquired Infections
2014 (16 IN TOTAL, 15 IN EFFECT) ,
Expands Medicaid to all individuals not eligible for Medicare under age 65 (children, pregnant women, parents, and adults without dependent children) with incomes up to 138% FPL and provides enhanced federal matching payments for new eligibles.
Implementation: January 1, 2014 (states have the option to expand coverage to childless adults beginning April 1, 2010)
Implementation Update: On August 17, 2011, CMS issued a proposed rule specifying the new rules for eligibility and enrollment in Medicaid and setting out the increased Federal Medical Assistance Payments (FMAP) rates. On March 23, 2012, CMS issued a final rule on the eligibility and enrollment issues. CMS issued the final rule on the FMAP rates on April 2, 2013.
On January 22, 2013, CMS issued a proposed rule addressing issues related to the Medicaid expansion, including coordination of Medicaid and CHIP coverage, eligibility notices, and appeals, the benefit package for new eligible, and premium and cost-sharing requirements. The final rule was issued on July 15, 2013.
States are required to make changes to their Medicaid eligibility and enrollment systems to streamline the process and coordinate eligibility determinations with the marketplaces. On April 19, 2011, CMS issued a final rule to provide enhanced federal funding for the systems upgrades and specifying the standards and conditions that must be met. On April 30, 2013, CMS issued guidance on the model streamlined application states may use and on state alternative applications.
Learn More: Which states are expanding Medicaid and which are not? Track the status of state actions.
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Assesses a fee of $2,000 per full-time employee, excluding the first 30 employees, on employers with more than 50 employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit. Employers with more than 50 employees that offer coverage but have at least one full- time employee receiving a premium tax credit, will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, excluding the first 30 employees.
Implementation: Delayed until January 1, 2015 for businesses with more than 100 employees. Delayed until January 1, 2016 for businesses with between 50 to 99 employees.
Implementation Update: On December 28, 2012, the IRS issued proposed regulations on the Employer Shared Responsibility provisions of the Affordable Care Act. On July 2, 2013, the Treasury Department announced a one-year delay in enforcement of this provision, postponing the effective date from Jan. 1, 2014, to Jan. 1, 2015. On July 9, 2013, the IRS and the Department of the Treasury issued an official notice announcing transition relief for 2014 from the Employer Shared Responsibility Provisions, noting that the provisions will be fully effective in 2015. On February 10, 2014, the Department of the Treasury issued a final rule delaying the Employer Shared Responsibility provision for businesses from 50 to 99 employees. The February 10 rule also redefines the employer requirement for businesses with 100 or more employees, requiring those companies to offer coverage to 70 percent of their employees by 2015, and to 95 percent of employees by 2016, in order to fulfill the requirement or pay the penalty. The rule also clarifies that volunteers will not be considered employees.
Learn more: Larger employers will have to pay a penalty if they don't provide comprehensive, affordable coverage to their employees. Find out how employer responsibilities will work with this simple infographic.
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Increase Federal Match for CHIP
2015 (1 IN TOTAL, 0 IN EFFECT) ,
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Health Care Choice Compacts
2016 (1 IN TOTAL, 0 IN EFFECT) ,
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Tax on High-Cost Insurance
2018 (1 IN TOTAL, 0 IN EFFECT) ,
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