Health Insurance Reform Is Law in the United States of America
March 23, 2010
A few hours ago President Obama signed into law H.R.3590, the Patient Protection and Affordable Care Act. And it was good.
The law will be gradually implemented over the next four years, with the major coverage expansions coming online in 2014. Here’s a handy table, lifted and adapted from Igor Volsky, indicating what happens when:
| Insurance Reform | Effective Date |
|---|---|
| No lifetime limits on coverage | 6 months after enactment |
| Restricted annual limits on coverage (defined by HHS) | 6 months after enactment |
| No rescissions (insurers can’t drop you when you get sick) | 6 months after enactment |
| Coverage of preventive services (Medicare and new insurance plans: no copay or deductible for preventive care) | 6 months after enactment |
| Extension of dependent coverage (stay on parents policy until 27th birthday) | 6 months after enactment |
| No discrimination based on salary | 6 months after enactment |
| No pre-existing condition exclusions | 6 months after enactment for children
(2014 for adults) |
| Medical loss ratios (insurers must spend min % of premium revenues on care — 80% individual and small group market, 85% large group market — and must rebate to customers if they don’t meet ratios) | 2011 |
| Summary of coverage provided to applicants and enrollees | 24 months after enactment |
| No annual limits | 2014 |
| Community rating (no rating based on health or gender, 3:1 age rating) | 2014 |
| Guaranteed issue | 2014 |
| Guaranteed renewal | 2014 |
| No discrimination based on health status | 2014 |
| Coverage of essential health benefits | 2014 |
| Limits on cost-sharing | 2014 |
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