What the new law does

2010

• Offers small businesses that choose to provide insurance to employees tax credits of up to 35 percent of premiums (effective immediately)

• Provides rebates up to $250 to seniors paying out-of-pocket drug costs due to the “doughnut hole” gap in Medicare prescription drug coverage (immediately)

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• Prohibits insurers from dropping customers when they get sick (effective six months after enactment)

• Prohibits denial of coverage for children with pre-existing conditions (six months)

• Prohibits lifetime caps on insurance payouts to the chronically ill (six months)

• Allows children to remain on parents’ insurance plans until age 26 (six months)

2011

• Requires insurers to spend at least 80 percent of premiums on medical services

• Begins phased-in fees and taxes on the health industry, starting with a $2.3 billion annual fee on drug makers

2013

• Imposes an additional 3.8 percent tax on investment income, and a 0.9 percent Medicare tax, on families with annual incomes above $250,000

2014

• Imposes an individual mandate—enforced by escalating fines starting at 1 percent of income—requiring most uninsured Americans to purchase insurance

• Provides subsidies to individuals and families with incomes up to 400 percent above the poverty line ($88,200 for a family of four) to help them buy health insurance

• Expands eligibility for Medicaid to anyone earning up to 133 percent of the poverty level—about $29,300 for a family of four

• Requires most employers to provide coverage to employees or pay penalties

• Prohibits denial of coverage of anyone with a pre-existing condition

• Establishes health-insurance exchanges to serve as a competitive insurance market, enabling those without employer-based insurance to shop for coverage

2018

• Imposes excise tax on “Cadillac” employer-provided health plans valued at more than $27,500 (family) or more than $10,200 (single)

• Completes multiyear expansion of health insurance to 32 million citizens.