---
title: Healthcare Bill Implementation Timeline- What Happens Now?
description: Healthcare reform timeline,Patient Protection and Affordable Care Act, senate bill
image: https://www.soldevila.com/hs-fs/file-26178765-jpg/images/patient_protection_and_affordability_act-resized-600.jpg
---
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# Soldevila.com Blog
## Healthcare Bill Implementation Timeline- What Happens Now?
Posted by Dale Soldevila on Tue, Mar 23, 2010
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** IMPLEMENTATION TIMELINE **
**2010**
Business tax credits: Businesses with no more than 25 employees and average annual wages of $40,000 would get tax credits to help provide insurance to employees. The credit would be up to 35% in 2010 of the employer's contribution if the employer pays 50% of the total premium cost. Effective date — **2010 tax year**, with the tax credit increasing to up to 50% in 2014
Temporary reinsurance program: A $5 billion program would be created for employers to provide coverage for retirees over the age of 55 who are not eligible for Medicare. Effective date — **June 2010** (expires Jan. 1, 2014)
Tanning salon tax: A tax of 10% would be imposed on the cost of indoor tanning services. Effective date — **Immediately**
Temporary high-risk insurance pool: A $5 billion pool would be created to provide health to individuals with pre-existing medical conditions who have been uninsured for at least six months. Effective date — **June 2010** (expires Jan. 1, 2014)
Pre-existing conditions: Insurers would be barred from denying coverage to children who have pre-existing medical conditions. Effective date — **Six months after enactment**
Adult dependent children: Insurance companies would have to provide coverage for dependent children up to the age of 26. Effective date — **Six months after enactment**
Insurance coverage limits: Insurance plans would be prohibited from placing lifetime limits on how much they pay out to individual policyholders and from rescinding coverage except in cases of fraud. Effective date — **Six months after enactment**
Preventive services: Health insurance plans would be required to cover preventive services such as immunizations for children and cancer screenings for women. Effective date — **Six months after enactment**
Medicare drug rebates: Medicare patients who face a gap in prescription drug coverage would receive a one-year, $250 rebate to help pay for medication. Effective -**Immediately**
**2011**
Tax changes on health care savings accounts: The federal tax on individuals who spend money from health-care savings accounts on ineligible medical expenses would double to 20%. Effective date — **Jan. 1, 2011**
Community health centers: Funding would increase by $11 billion for community health centers that provide medical care to patients who can't afford it. Effective date — **Oct. 1, 2011 **
Medicare "doughnut hole": Drug companies would provide a 50% discount on brand name prescription drugs for seniors who face a gap in drug coverage. More subsidies would be phased in through 2020, when the coverage gap would be closed. Effective date — **Jan. 1, 2011 **
Primary care: Primary care doctors and general surgeons practicing in areas that lack primary care doctors would receive a 10% bonus payment under Medicare. Effective date — **Jan. 1, 2011 through 2015**
Long-term care: A voluntary long-term care program called CLASS would be created. After at least five years of contributions, enrollees would be entitled to a $50-a-day cash benefit to pay for long-term care. Effective date — **Jan. 1, 2011**
New annual fees on Pharmaceutical companies: A total annual fee of $2.5 billion would be imposed on pharmaceutical manufacturers. Effective date — **Jan. 1, 2011**
Insurance rebates: Health insurance companies would be required to provide rebates to enrollees if they spend less than 85% of their premium dollars on health care as opposed to administrative costs. Effective date — **Jan. 1, 2011 **
**2012-13**
Annual fees on Pharmaceutical companies: The annual fee on pharmaceutical manufacturers would increase to $3 billion each year through 2016. Effective date — **Jan. 1, 2012**
Contribution limits on health care savings accounts: The limit on how much individuals could contribute to flexible savings accounts that let people set aside money tax free for health costs would be set at $2,500. Currently, employers set the limit. Effective date — **Jan. 1, 2013**
Itemized deductions for unreimbursed medical expenses: The threshold for deducting such expenses would increase from 7.5% of adjusted gross income to 10%. Effective date — **Jan. 1, 2013**
Medicare taxes: The Medicare tax rate would increase by 0.9 percentage points -- from 1.45% to 2.35% -- on earnings over $200,000 for individuals and $250,000 for families. Also, for the first time, a 3.8% Medicare tax would be imposed on investment income. Effective date — **Jan. 1, 2013**
**2014**
Individual mandate: Most Americans would be required to buy health insurance or pay fines of $95 per individual up to $285 per family or 1% of taxable household income, whichever is greater. Effective date **— Jan. 1, 2014**
Employer requirements: Companies with 50 or more employees would pay a fine if any of their full-time workers qualified for federal health care subsidies. Effective date — **Jan. 1, 2014**
Individual mandate: Most Americans would be required to buy health insurance or pay fines of $95 per individual up to $285 per family or 1% of taxable household income, whichever is greater. Effective date — **Jan. 1, 2014**
Employer requirements: Companies with 50 or more employees would pay a fine if any of their full-time workers qualified for federal health care subsidies. Effective date — **Jan. 1, 2014 **
Medicaid expansion: The program for low-income Americans under the age of 65 would expand by increasing the income eligibility to 133% of federal poverty, or $29,327 for a family of four. Effective date — **Jan. 1, 2014**
Federal subsidies: Federal subsidies, which vary based on household income, would help offset the cost of buying insurance for Americans and legal residents who qualify. Effective date — **Jan. 1, 2014**
Annual fee on insurance companies: An annual fee totaling $8 billion would be imposed on health insurance companies. Effective date — **Jan. 1, 2014**
Health insurance exchanges: A state-based health care exchange -- a marketplace where uninsured individuals and small businesses could comparison shop for insurance policies -- would be created. Effective date — **Jan. 1, 2014**
**2015-16**
Individual mandate: Penalties for not carrying insurance would increase to $325 for each family member up to $975 per family or 2% of taxable household income, whichever is greater. Effective date — **Jan. 1, 2015**
Annual fee on insurance companies: The annual fee on health insurance companies would increase to $11.3 billion. Effective date — **Jan. 1, 2015**
Individual mandate: Penalties for not carrying insurance would increase to $695 for each family member up to $2,085 per family or 2.5% of taxable household income, whichever is greater. Effective date — **Jan. 1, 2016** (Adjusted for inflation after 2016).
**2017-18******
Annual fees on pharmaceutical companies: The annual fee on pharmaceutical manufacturers would increase to $3.5 billion in 2017 and $4.2 billion in 2018. Effective date — **Jan. 1**
Annual fee on insurance companies: The annual fee on health insurance companies would increase to $13.9 billion in 2017 and $14.3 billion in 2018. Effective date — **Jan. 1, 2017**
Excise tax on high-cost insurance plans: A 40% excise tax would be imposed on health care plans that cost more than $10,200 for individual coverage and $27,500 for family coverage. Effective date — **Jan. 1, 2018**
*Disclaimer…..*
*This is only a summary of the proposed timelines. Please refer to [http://www.opencongress.org/bill/111-h3590/show](http://www.opencongress.org/bill/111-h3590/show)*
*Or you can see a condensed version of the Senate Healthcare Bill along with the proposed House Reconciliation bill at [http://www.kff.org/healthreform/upload/housesenatebill_final.pdf](http://www.kff.org/healthreform/upload/housesenatebill_final.pdf)*
Tags: [patient protection act](https://www.soldevila.com/blog/topic/patient-protection-act), [health reform](https://www.soldevila.com/blog/topic/health-reform), [National Health Reform](https://www.soldevila.com/blog/topic/national-health-reform), [Healthcare bill timeline](https://www.soldevila.com/blog/topic/healthcare-bill-timeline)
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