In March 2010, Congress passed the Patient Protection and Affordable Care Act (ACA). The ACA is a piece of legislation with many provisions phasing from 2012 to 2014. Below, we have provided a brief outline of the key provisions taking effect over the next 3 years.
Key Provisions of the Affordable Care Act That Take Effect in 2012
- Medicare hospital value-based purchasing program
- Increase in physician quality reporting requirements in Medicare
- Additional Medicare pilot programs on alternative payment methodologies, e.g., accountable care organizations
- Increased requirements for hospitals to maintain not-for-profit status
- Fees from insured (including self-insured) plans transferred to the Patient-Centered Outcomes Research Trust Fund
Key Provisions of the Affordable Care Act That Take Effect in 2013
- Increase Medicare payroll tax by 0.9% on high-income earners
- Impose a 3.8% tax on net investment income of high-income individuals
- $500,000 cap on health insurers’ deduction for executive compensation
- Eliminate employer deduction for Medicare Part D subsidy
- FSA limitations
- Excise tax on medical device manufacturers and importers
- Medical expense deduction floor increases to 10%
- Nationwide bundled payment pilot begins in Medicare
- Increased Medicaid reimbursement for primary care
- Medicare physician comparison data available to the public
- Reductions in Medicare payments for select hospital readmissions
- Expanded coverage of preventive services by Medicaid
Key Provisions of the Affordable Care Act That Take Effect in 2014
- Employer mandate and individual mandate
- Employer and insurer reporting requirements
- New health insurance market reforms take effect
- State health insurance Exchanges established
- Premium tax credits and cost-sharing subsidies available to certain individuals in Exchange insurance products
- Medicaid expansion to new populations (100% federal match to states for newly-eligible populations through 2016)
- Annual fee on health insurers
- Medicare/Medicaid DSH payment cuts begin
- Independent Payment Advisory Board (IPAB) issues first report to Congress if Medicare spending exceeds growth target
