Government Watch

Health Care Reform Timeline for Consumers



  • Individuals making $200,000 a year or couples making $250,000 would have a higher Medicare payroll tax of 2.35 percent on earned income – up from the current 1.45 percent. A new 3.8 percent tax on unearned income, such as dividends and interest, also added.
  • Contributions to flexible spending accounts (FSAs) limited to $2,500 a year – indexed for inflation. And the threshold for deducting medical expenses on taxes goes from 7.5 percent to 10 percent of income.
  • Medical device manufacturers have a 2.9 percent sales tax on medical devices, with exemptions for some, like eyeglasses, contact lenses and hearing aids.
  • No more deduction for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D-eligible retirees.

Administrative Simplification

  • Eligibility verification standards on how health plans must verify each individual’s health plan eligibility and what that person’s financial responsibility might be for specific services either prior to or at the end of service.
  • Claim status transactions outlining required timeframes by which health plans must respond to claim status inquiries from providers, including the adjudication and appeals processes.


Coverage Mandates & Subsidies

  • New individual and employer coverage responsibilities.
  • New individual affordability tax credits and expanded small business tax credits.

Health Insurance Exchange & Insurance Reforms

  • State individual and small group health insurance exchanges operational.
  • Guaranteed issue, guaranteed renewability, modified community rating and minimum benefit standards (“essential benefits” plan) effective.
  • No more lifetime or annual dollar limits for essential benefits.
  • No more excessive waiting periods.
  • No pre-existing condition exclusions.
  • New health plan disclosure and transparency requirements.
  • New uniform insurance rating reforms.
  • Provider non-discrimination requirements.

New Taxes on Health Insurers

Medicaid and Medicare Reform

  • Medicaid expanded to cover low-income individuals under age 65 up to 133 percent of the federal poverty level – about $28,300 for a family of four.
  • Minimum medical loss ratio of 85 percent required for Medicare Advantage plans.

Administrative Simplification

  • Electronic Fund Transfer (EFT) standards for automated reconciliation of payment to remittance advice.
  • Claim payment/remittance standards for re-association of the claim payment with the remittance advice when health plans process electronic payments.
  • Health plan certification required by health plans for eligibility verification, claim status, electronic fund transfer and claim payment/remittance compliance.
  • Health plan identifier (HPID) and unique identification of health plans in order to facilitate routing of electronic transactions between the plan and providers.



If You Enjoy Articles Like This - Subscribe to the AMAC Daily Newsletter!

Sign Up Today
Notify of
Oldest Most Voted
Inline Feedbacks
View all comments
8 years ago

As employers start tossing their employees into the state exchanges to avoid the absurd new costs, rules and regulations, insurance premiums balloon to $20,000 annually for a family of four in order to cover all the mandated items from HHS that are being larded on to “the approved standard policies” and doctors and hospitals get buried under the ever-rising mountain of government paperwork, which of course will reduce the amount of time they can actually see patients, I’m sure everyone will be singing the praises of Obamacare. At least that’s the fantasy that Obama and the Democrats are still deluding themselves with. They of course are all completely exempt from this wonderful, cost-saving law that was pushed through despite 60 percent of the public being against it. Fun times ahead everyone. So buckle up and enjoy the ride.

8 years ago

The federal government should just get out of the health care business. The only exception should be Medicare Part A, which people have paid into for ages. How to care for those who can’t afford their health care?….have government–sponsored walk in clinics where everyone must pay something for their care and patients will be charged according to their ability to pay. The health care provided at these clinics should be the minimum for the ailment, and that includes not doing anything for people whose best cure would be better exercise, nutrition, and lifestyle choices.

Just look at these new taxes in 2013 to fund ObamaCare. They’re totally insane.

Would love your thoughts, please comment.x