Six months after enactment:

• Bar insurers from denying people coverage when they get sick.
• Bar insurers from denying coverage to children with pre-existing conditions.
• Bar insurers from imposing lifetime caps on coverage.
• Require insurers to allow people to stay on their parents' policies until they turn 26.

Nine months after enactment

• 50% of the donut hole will be covered. Eventually, the health care reform bill will close the donut hole entirely

Within A Year:

• Provide a $250 rebate this year to Medicare prescription drug beneficiaries whose initial benefits run out when they enter the donut hole.
• Require new insurance policies to cover certain preventive-care measures with no out-of-pocket cost to the consumer.
• Require Insurance companies to stop imposing lifetime coverage limits on your insurance.
• Sharply limit annual caps on your insurance.
• Require Insurers with unusually high administrative costs to offer rebates to their customers, and every insurance company has to reveal how much it spends on overhead.

2011:

• Require individual and small group market plans to spend 80% of premium dollars on medical services. Large group plans would have to spend at least 85%.
• Taxes begin being levied on drug manufacturers.
• Physicians' Medicare fees will be cut more than 25% unless the sustainable growth rate is permanently repealed by Congress; -
• Initiate Medicare bonus of 10%over five years for primary care and general surgery (family medicine, internal medicine, geriatrics and pediatrics)

2012:

• Businesses must file Form 1099s for all business-to- business transactions of $600 or more.

2013 :

• Increase the Medicare payroll tax and expand it to dividend, interest and other unearned income for singles earning more than $200,000 and joint filers making more than $250,000.
• Require public reporting of physician performance to begin.
• Begin testing  Medicare pilot programs care payments based on "quality over quantity" of services rendered.
• Make fewer medical expenses tax deductible.
• Raise wage taxes from 1.45% to 2.35%;
• New tax of 3.8 percent levied on unearned income streams like interest and dividends
• New tax of 2.9 percent on medical device sales.

2014:

• Provide subsidies for families earning up to 400% of poverty level, currently about $88,000 a year, to purchase health insurance.
• Require most employers to provide coverage or face penalties.
• Require most people to obtain coverage or face penalties for noncompliance.
• Create  state insurance exchanges for individuals and small businesses to purchase coverage.
• Prohibit Insurance companies from denying coverage for pre-existing conditions.
• Expand Medicaid to all Americans under age 65 earning up to 133% of the federal poverty level.
• Increase Subsidies for some small business providing coverage to employees.

2015

• Initiate independent Payment Advisory to make recommendations for cutting Medicare costs.

2016:

• Penalties for individuals refusing to purchase insurance rise to 2.5% of taxable income or $695, whichever is greater.
• Multi-state compacts allowed to sell policies across state lines

2018

• Impose a 40% excise tax on high-end insurance policies.

2019

• Expand health insurance coverage to 32 million people.

[Source: Speaker of the House, Congressional Budget Office, Kaiser Family Foundation via McClatchy Newspapers article 21 Mar 2010 ]

Ben Krause - Virginia  Beach

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