Insurance reforms were implemented between 2010-2018 that prohibited lifetime or annual limits on coverage, pre-existing condition exclusions, and cancellations. Standard coverage documents and definitions were also developed. A "Cadillac tax" on high-cost employer health plans went into effect in 2018. Hospitals with high readmission rates faced reduced Medicare payments beginning in 2012. Individuals and families making over $200,000/$250,000 respectively paid higher Medicare taxes starting in 2013.

1. ExpertQuote Health Reform Timeline
Insurance reforms: Insurance reforms: Hospitals, doctors and •Individuals making $200,000 a year Coverage Mandates & New tax (”Cadillac tax”) on
payers encouraged to join or couples making $250,000 would Subsidies: employer- sponsored health
•No lifetime benefit limits •New uniform coverage documents have a higher Medicare payroll tax
based on dollar amounts. and standard definitions are
forces in “accountable care of 2.35% on earned income-up from plans that offer policies with
•New individual and employer
developed. organizations.” the current 1.45%. A new 3.8% tax coverage responsibilities.
generous coverage levels.
•Allowed restricted yearly on unearned income, such as
limits on the dollar value •Must have minimum medical loss Hospitals with high rates of dividends and interest, also added. •New individual affordability tax
of certain benefits. ratios. credits and expanded small
preventable readmissions •Contributions to flexible spending business tax credits.
•No coverage rescissions/ Other: facing reduced accounts (FSAs) limited to $2,500 a
cancellations (except for Medicare payments. year-indexed for inflation. And the
Health Insurance Exchange
fraud or intentional •Yearly fee for brand-name drug threshold for deducing medical
misrepresentation). manufacturers. expenses on taxes goes from 7.5% & Insurance Reforms:
to 10% of income.
•No cost-sharing obligations •State individual and small group
•Start of voluntary long-term care
for preventative services. •Medical device manufacturers have health insurance exchanges
insurance program giving a cash
a 2.9% sales tax on medical devices operational.
benefit to help those with
•Must have dependant disabilities stay in their homes or with exemptions for some, like
coverage up to age 26. eyeglasses, contact lenses and •Guaranteed issue, guaranteed
pay nursing home costs, benefit
hearing aids. renewability, modified community
starts 5 years after paying
•New internal and external rating and minimum benefit
coverage fee.
appeal processes. standards (”essential benefits” plan)
effective.
•No pre-existing condition
exclusions for dependant •No more lifetime and yearly dollar
children (under 19 years of age). limits for essential benefits.
•New health plan disclosure New taxes on health
and transparency insurers.
requirements.
2018
2014 “Cadillac Tax”
is imposed.
Pre-existing
2013 condition exclusions
2012 Individuals making are prohibited.
$200,000 a year, or
2011 Hospitals with high rates of
couples making $250,000
have a higher Medicare
2010 preventable readmissions payroll tax.
Employers are face reduced Medicare
required to report the payments.
Dependant coverage value of health care benefits
up to age 26 is mandated. on employees’ W2 tax statements.