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Small Business Employee Benefits and HR Blog

Health Care Reform Timeline 2010-2020

Over the last few weeks, we created a health care reform timeline for each year from 2010-2020. Here is all the information in one place.

Health Care Reform Timeline - 2010

New Programs in 2010

Health Care Reform Timeline   2010 resized 600

  • The temporary retiree reinsurance program took effect

  • The national Pre-existing Condition Insurance Pool (PCIP) was launched.

  • The Small Business Tax Credit took effect. 

  • The Medicare members who reached the "donut hole" received a $250 rebate.

Insurance Reforms in 2010

  • Lifetime dollar limits were disallowed on essential benefits.

  • Restricted yearly limits were allowed on the dollar value of certain benefits.

  • Coverage rescissions/cancellations were disallowed except for fraud or intentional misrepresentation.

  • Cost-sharing obligations were disallowed for preventive services in network.

  • Dependent coverage, if provided, was required up to age 26.

  • Enhanced internal and external appeal processes and requirements took effect.

  • Pre-existing condition exclusions were disallowed for enrollees (under 19 years of age).

 

Health Care Reform Timeline - 2011

New Programs in 2011

  • The Medicare members who reached the "donut hole" got a 50 percent discount on brand-name drugs.

  • Primary care doctors and general surgeons practicing in underserved areas received a 10 percent Medicare bonus.

  • The new voluntary long term care insurance program (CLASS) was suppose to become effective, but was not implemented.

    health care reform timeline 2011

Insurance Reforms in 2011

  • The new uniform coverage documents and standard definition rules (effective 2012) were proposed.

  • The Medical Loss Ratio (MLR) rules took effect:

    • The minimum MLR for the Small Group or Individual market became 80%

    • The minimum MLR for the Large Group market became 85%

  • The rate review rule requiring insurers of individual/small group plans to provide detailed information for any proposed increase equal to or greater than 10 percent, along with the reason for the proposed increase took effect.  

  • Medicare Advantage cost-sharing limits took effect.

  • Medicare Advantage plans began restructuring of payments and freeze 2011 payments at 2010 levels.

Other Insurance-Related Reforms in 2011

  • The new rule excluding costs for over-the-counter drugs not prescribed by a doctor from being reimbursed through an HSA, FSA, or HRA took effect.

  • The new rule requiring employers to report the value of health care benefits on employee W2 tax statements took effect and was optional for 2011.

 

Health Care Reform Timeline - 2012

New Programs in 2012health care reform timeline 2012

  • New Accountable Care Organization (ACO) Medicare program allowing providers organized as accountable care organizations (ACOs) that meet quality thresholds to share in the cost savings they achieve for the Medicare program took effect.

  • New procedures for screening, oversight, and reporting for providers and suppliers that participate in Medicare, Medicaid, and CHIP took effect.

  • Reduced rebates paid to Medicare Advantage plans took effect.

  • New Annual Fees on the pharmaceutical manufacturing sector took effect.

Insurance Reforms in 2012

  • New uniform Summary of Benefits and Coverage (SBC) requirement to help consumers compare health insurance coverage options took effect.

  • New hospital value-based purchasing program in Medicare to pay hospitals based on performance on quality measures took effect.

  • Reduced Medicare payments to hospitals to account for excess hospital readmissions took effect.

 

Health Care Reform Timeline - 2013

New Programs in 2013health care reform timeline 2013

  • Increase in the Medicare Part A (hospital insurance) tax rate on wages by 0.9% on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly takes effect.

  • New $2,500 annual limit on contributions to health flexible spending accounts (FSAs) takes effect. 

  • Increase in the threshold for the itemized deduction for unreimbursed medical expenses from 7.5% of adjusted gross income to 10% of adjusted gross income takes effect.

  • New 2.9% tax on medical device manufacturers takes effect.

  • Phase-in of federal subsidies for brand-name prescriptions filled in the Medicare Part D coverage gap takes effect.

  • The tax-deduction for employers who receive Medicare Part D retiree drug subsidy payments is eliminated.

  • New Consumer Operated and Oriented Plan (CO-OP) Program takes effect.

  • Extended CHIP funding takes effect. 

Insurance Reforms in 2013

  • New Medicaid programs for preventative services and primary care take effect.

 

Health Care Reform Timeline - 2014

New Programs in 2014health care reform timeline 2014

  • New tax requiring U.S. citizens to have qualifying health coverage takes effect.

  • New tax requiring certain large employers to provide health coverage takes effect.

  • Medicaid expansion to individuals not eligible for Medicare with incomes up to 133% FPL takes effect.

  • New premium tax subsidies for families with incomes between 133-400% of the federal poverty level take effect.

  • New cost-sharing tax subsidies for families with incomes up to 250% of the federal poverty level take effect.

  • New temporary reinsurance program takes effect.

Insurance Reforms in 2014

  • New state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges take effect. 

  • New guaranteed issue rules with uniform insurance rating requirement take effect.

  • New guaranteed renewability requirement takes effect. 

  • Full abolition of annual limits on essential health benefits takes effect.

  • Prohibition of waiting periods greater than 90 days takes effect.

  • Prohibition of pre-existing condition exclusions takes effect.

  • New essential health benefits package limiting annual cost-sharing to the Health Savings Account limits takes effect.

  • Minimum medical loss ratio of 85 percent requirement for Medicare Advantage plans takes effect.

 

Health Care Reform Timeline - 2015

New Programs in 2015health care reform timeline 2015

  • Independent Payment Advisory Board (IPAB) for Medicare that submits proposals to Congress for fast-track approval to reduce costs & improve quality takes effect.

  • State eligibility to receive a 23% increase in the CHIP federal match rate (FMAP) takes effect.

  • State option, subject to HHS approval, to shift children eligible for CHIP to a health plan sold in the state insurance exchange takes effect

Insurance Reforms in 2015

  • New provision that ties physician payments to the quality of care they provide takes effect.

 

Health Care Reform Timeline - 2016

New Programs in 2016health care reform timeline 2016

  • New program allowing states to form health care choice compacts allowing insurers to sell policies in any state participating in the compact take effect.

Insurance Reforms in 2016

  • All businesses with 100 or fewer FTE employees will be able to purchase insurance through the state SHOP exchange. 

Health Care Reform Timeline - 2017health care reform timeline 2017

New Programs in 2017

  • No significant new programs

Insurance Reforms in 2017

  • State ability to allow large employers (with 100+ employees) to provide coverage through a SHOP Exchange takes effect.

 

Health Care Reform Timeline - 2018

New Programs in 2018health care reform timeline 2018

  • New tax on high-cost health insurance imposing an excise tax on insurers of employer-sponsored health plans with aggregate expenses that exceed $10,200 for individual coverage and $27,500 for family coverage takes effect.

Insurance Reforms in 2018

  • No significant insurance reforms

 

Health Care Reform Timeline - 2019health care reform timeline 2019

New Programs in 2019

  • Temporary comparative effectiveness research (CER) fee program ends.

Insurance Reforms in 2019

  • No significant insurance reforms

 

Health Care Reform Timeline - 2020

health care reform timeline 2020

New Programs in 2020

  • Full phase out of the coverage gap known as the “Donut Hole” in the Medicare Part D prescription drug benefit takes effect. 

Insurance Reforms in 2020

  • No significant insurance reforms

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