America's Affordable Health Care Act of 2009

Legislation passed by Congress and signed into law in March 2010, opens a new chapter in American health care. The health care law is comprised of two parts, the Patient Protection and Affordable Care Act, signed on March 23, and the Health Care and Education Reconciliation Act, signed on March 30. The second, or amended version of the original act, now referred to as the Affordable Care Act, is the current law of the land. According to the Obama administration, the Act's primary focus is putting American consumers back in charge of their health care coverage. The bulk of comprehensive health care changes roll out over a five-year period according to language in the Affordable Care Act.

2010

• Many seniors who reached a gap in prescription drug coverage through Medicare received a $250 rebate check in June 2010. On Sept. 23, 2010 many aspects of the new law went into affect. For instance, if a young adult has no insurance at his place of employment, he may remain under his parent's plan until he turns 26 years of age; all new health plans must cover identified preventive services without charging a deductible; insurance companies are now prohibited from imposing lifetime dollar amounts on essential benefits; and new rules disallow denial of coverage for children under the age of 19 due to a pre-existing condition. Other 2010 initiatives included the awarding of grants to open offices to help citizens negotiate the private health insurance system; allocated $15 billion for establishment of public health programs that focus on keeping Americans healthy; and provided funding to assist medically underserved communities in keeping health care professionals though increased payments to the providers.

2011

• Effective Jan. 1, 2011, seniors who reach the prescription-coverage gap associated with Medicare Part D brand-name drugs will get a 50 percent discount of future purchase of the prescribed drugs. The Affordable Care Act closes the gap in 2020. Also on Jan. 1, all Medicare recipients will receive free preventative services; insurance companies must spend 85 percent of all premium dollars on health care services and quality improvement when collecting premiums from large employers and 80% when selling to individuals or small companies; and revamps Medicare Advantage plans gradually to more closely resemble coverage available to those without such a plan. By Oct 1, administrative funding becomes available for the Independent Payment Advisory Board, which develops and submits proposals to Congress and the president aimed at extending the solvency of the Medicare Trust Fund. Also on Oct. 1, the Community First Choice Option kicks in, which allows states to provide home and community based care through Medicaid.

2012

• When Jan. 1, 2012 rolls around, the law invokes incentives for physicians to form Accountable Care Organizations. These groups focus on coordinating patient care and reducing unnecessary hospital admissions. As an added incentive, if these groups reduce costs, they can keep a percentage of the money they save. By Oct. 1, the law creates a voluntary long-term-care insurance program, which allows cash benefits to adults who become disabled; begins the process of converting all medical paperwork to electronic files by a series of changes that standardize billing and other medical forms; and establishes a Value-Based Purchasing program in original Medicare that offers financial incentives to hospitals that improve quality of care.

2013

• By Jan 1, 2013, the number of citizens receiving preventive care should increase because the law provides funding to state Medicaid programs that choose to offer preventive care services with little to no costs attached; the new law allows the federal government to fully fund payments to primary care physicians, reimbursing them at 100 percent of the Medicare payment rates when caring for Medicaid patients; implements a bundling program to encourage doctors and hospitals to bundle billing under one umbrella, thus improving the current fragmented system; and extends insurance coverage for children not eligible for Medicaid an additional two years.

2014

• By 2014, all discrimination against pre-existing medical conditions or gender will be eliminated by the Affordable Care Act. On Jan. 1, if an employer does not offer insurance, employees can buy at the Exchange, a new transparent and competitive insurance store; individuals who can afford insurance must purchase a basic policy or pay a fee; if an employee cannot afford an employer-offered plan, the employee my import employer funds normally used to pay for his insurance and use that dollar amount at the Exchange to purchase affordable insurance; all Americans who earn less that 133 percent of the poverty level will be eligible for Medicaid; advanceable tax credits will become available to help pay insurance costs for middle income wage earners who do not have access to affordable insurance and have incomes between 100 and 400 percent of the poverty line; eliminates annual limits on insurance coverage; and allows business tax credits of up to 50 percent of the employer-paid portion of an employee's health insurance premiums.