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Health Reform Law Implementation Timeline
Summary of Major Provisions Affecting the U.S. Health System and Health Care Industry
Start of Maintenance of Effort (MOE) requirements Provisions for Medicaid and the Children's Health Insurance Program
Consumer Health Care Information web site online
Medicaid Prescription Drug Rebate increases and expands to managed care
Authorization for Medicare Advantage Special Needs Plans (SNPs) extended through 2013
2010-2014: States may opt to expand Medicaid eligibility early
Implementation of select health insurance market reforms
Consumer Health Care Information web site online
Medicaid Prescription Drug Rebate increases and expands to managed care
Authorization for Medicare Advantage Special Needs Plans (SNPs) extended through 2013
2010-2014: States may opt to expand Medicaid eligibility early
Implementation of select health insurance market reforms
Executive compensation deductibility for health insurers newly limited
2013-2014: Medicaid Primary Care Providers paid at 100 percent of Medicare rates
Medicare hospital insurance tax rate increase for high‐wage earners begins
Medical device excise tax goes into effect
Dual Eligible SNPs required to obtain National Committee for Quality Assurance approval
2013-2014: Medicaid Primary Care Providers paid at 100 percent of Medicare rates
Medicare hospital insurance tax rate increase for high‐wage earners begins
Medical device excise tax goes into effect
Dual Eligible SNPs required to obtain National Committee for Quality Assurance approval
2015 through 2016: Annual health insurer assessment at $11.3 billion
2017-2020: FMAP for newly eligible population phases down to 90 percent
2017: Annual Health Insurer Tax Assessment at $13.9 billion
2017: Annual Health Insurer Tax Assessment at $13.9 billion
FMAP for Medicaid newly eligibles drops to 93 percent
2018: Annual Health Insurer Tax Assessment at $14.3 billion
High-cost health plan excise tax in effect
2018: Annual Health Insurer Tax Assessment at $14.3 billion
High-cost health plan excise tax in effect
Commercial health insurance plans required to report Medical Loss Ratios (MLR)
Medicare Advantage 2011 county rates frozen at 2010 levels
Employers to disclose value of health benefits on form W-2s
Creation of simple cafeteria plan for small businesses
Increases tax to 20 percent for withdrawals from health savings accounts
Medicare Advantage 2011 county rates frozen at 2010 levels
Employers to disclose value of health benefits on form W-2s
Creation of simple cafeteria plan for small businesses
Increases tax to 20 percent for withdrawals from health savings accounts
2012‐2016: Medicare Advantage quartile rates, quality adjustment and quality-based rebates phases in
Dual Eligible SNPs required to contract to participate (2012 and beyond)
Start of demonstration projects for Pediatric Accountable Care Organizations
Start of Medicare Shared Savings Program
Dual Eligible SNPs required to contract to participate (2012 and beyond)
Start of demonstration projects for Pediatric Accountable Care Organizations
Start of Medicare Shared Savings Program
Medicare Advantage minimum MLR in effect with penalties
First year of Annual Health Insurer Tax Assessment at $8 billion across industry, including managed care
Establishment of Health Insurance Exchanges
Individual and employer responsibility requirements in effect
Implementation of remaining health insurance market reforms
Expansion of National Medicaid eligibility to 133 percent of the Federal Poverty Level
Through 2016, 100 percent Federal Medical Assistance Percentages (FMAP) for Medicaid newly eligible enrollees; enhanced FMAP of 23 percent for CHIP (2014 through 2016, only)
First year of Annual Health Insurer Tax Assessment at $8 billion across industry, including managed care
Establishment of Health Insurance Exchanges
Individual and employer responsibility requirements in effect
Implementation of remaining health insurance market reforms
Expansion of National Medicaid eligibility to 133 percent of the Federal Poverty Level
Through 2016, 100 percent Federal Medical Assistance Percentages (FMAP) for Medicaid newly eligible enrollees; enhanced FMAP of 23 percent for CHIP (2014 through 2016, only)
2019 and Beyond: Annual Health Insurer Tax Assessment at $14.3 billion plus the percentage growth of national premium dollars
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Medicaid, CHIP and Medicare Advantage Timeline
Summary of Major Provisions Affecting Select Publicly Funded Health Care Programs
2010-2014: State option to expand Medicaid eligibility to 133 percent of the Federal Poverty Level
Medicaid Prescription Drug Rebate increases to 23.1 percent and expands to Medicaid managed care enrollees (effective March 23, 2010)
Children’s Health Insurance Program (CHIP) reauthorized to 2013. Extended through federal fiscal year (FFY) 2015
Authorization for Medicare Advantage Special Needs Plans (SNPs) extended through 2013
Maintenance of Effort (MOE) for adults in Medicaid in effect through Dec. 31, 2013 and for children in Medicaid through Sept. 30, 2019. MOE for children in CHIP ends Sept. 30, 2015
Medicaid Prescription Drug Rebate increases to 23.1 percent and expands to Medicaid managed care enrollees (effective March 23, 2010)
Children’s Health Insurance Program (CHIP) reauthorized to 2013. Extended through federal fiscal year (FFY) 2015
Authorization for Medicare Advantage Special Needs Plans (SNPs) extended through 2013
Maintenance of Effort (MOE) for adults in Medicaid in effect through Dec. 31, 2013 and for children in Medicaid through Sept. 30, 2019. MOE for children in CHIP ends Sept. 30, 2015
2013-2014: Medicaid Primary Care Providers paid at 100 percent of Medicare rates with full federal match
Two year phase-in of modified benchmarks for Medicare Advantage ends
SNPs required to obtain National Committee for Quality Assurance approval the Health Insurance Exchange
Two year phase-in of modified benchmarks for Medicare Advantage ends
SNPs required to obtain National Committee for Quality Assurance approval the Health Insurance Exchange
April 1: Deadline for the Health and Human Services Secretary to certify Qualified Health Plans in the Health Insurance Exchange plans similar to CHIP
2017-2020: FMAP for newly eligible population phases down to 90 percent
Dual Eligible SNPs without a state contract can participate in Medicare Advantage through 2012
Medicare Advantage 2011 county rates frozen at 2010 levels
Medicare Advantage 2011 county rates frozen at 2010 levels
2012‐2016: Medicare Advantage quartile rates, quality adjustment and quality-based rebates phases in
Dual Eligible SNPs required to contract to participate (2012 and beyond)
Start of demonstration projects for Pediatric Accountable Care Organizations
Start of Medicare Shared Savings Program
Dual Eligible SNPs required to contract to participate (2012 and beyond)
Start of demonstration projects for Pediatric Accountable Care Organizations
Start of Medicare Shared Savings Program
Mandatory expansion of Medicaid eligibility to 133 percent of the Federal Poverty Level
Through 2016, 100 percent Federal Medical Assistance Percentages (FMAP) for newly eligible enrollees
Enhanced FMAP of 23 percent for CHIP (through FFY 2015)
Medicare Advantage minimum Medical Loss Ratio in effect with penalties
Through 2016, 100 percent Federal Medical Assistance Percentages (FMAP) for newly eligible enrollees
Enhanced FMAP of 23 percent for CHIP (through FFY 2015)
Medicare Advantage minimum Medical Loss Ratio in effect with penalties
