A Look Back At The Health Reform Law On Its 2nd Birthday

Here are the law's major implementation milestones:


  1. March 23, 2010: President Obama signs the Patient Protection and Affordable Care Act. The law immediately provides several benefits, including tax credits for small businesses that purchase health care for workers and a $250 payment to seniors who hit the Medicare drug coverage gap known as the “doughnut hole.”
  2. May 5, 2010: HHS releases the final rule on the “Early Retiree Reinsurance Program” that provides $5 billion to help employers fund health costs for retirees who are not yet old enough to qualify for Medicare. Employers began to apply for funding on June 1.
  3. Early Retiree Reinsurance Program (09/09/2010 Webchat)
  4. Health Reform & Young Adults (05/11/2010 Web chat)
  5. June 14, 2010: IRS releases notice of new requirements for nonprofit hospitals to maintain their nonprofit status. Among other things, nonprofit hospitals must maintain a written financial assistance policy and make it available to patients. The nonprofit hospital provisions were inserted by Sen. Chuck Grassley and Sen. Max Baucus in the Senate Finance Committee, part of bipartisan talks aimed at finding middle ground on health reform.
  6. June 17, 2010: HHS releases rules on how group health plans can keep their “grandfathered” status. In an effort to gain public support for the health law, advocates promise that consumers with insurance plans they like will not have to change that coverage. Plans that were in effect when the health law was signed and meet certain basic provisions do not have to meet all requirements of the law.
  7. Health Reform: Grandfathering Your Current Insurance Plan (06/14/2010 Press Conference)
  8. June 22, 2010:  The IRS and HHS issue a rule on “Patient’s Bill of Rights.” These initial provisions bar insurance companies from denying coverage to children with medical problems and from rescinding coverage if a beneficiary gets sick; protect consumers' ability to choose doctors in their plans; and end lifetime caps on coverage.
  9. The Affordable Care Act & The Patient's Bill of Rights
  10. July 19, 2010: HHS releases rule on what services are to be mandated for full, cost-free coverage as preventive care.

  11. July 22, 2010: HHS releases rule that requires insurers to standardize their consumers' appeals process. In 2011, the administration scales back some of those provisions. See related KHN content: New Rules Guarantee Patients' Right To Appeal Insurance Denials or HHS Scales Back Rules On Health Insurance Appeals

  12. Sept. 23, 2010: Key consumer protections take effect, including extended coverage for adult children up to the age of 26, safeguards for continuing coverage for children with medical problems up to age 19, the end of insurers’ ability to stop coverage for beneficiaries who get sick, the guarantee of full coverage for some preventive screenings and treatments, and an end to annual limits on coverage in many plans. See related KHN story: Health Law's 8 New Changes To Insurance -- With 7 Caveats.

  13. Sept. 23, 2010: The Government Accountability Office announces 19 members of the board of the Patient-Centered Outcomes Research Institute (PCORI), which is charged with helping to improve health care by commissioning research on evidence-based medicine. See related KHN story: Panel Formed To Give Consumers Reliable Treatment Information.
  14. Nov. 22, 2010: HHS releases Medical Loss Ratio preliminary rule. Insurance companies in the individual and small group markets must spend 80 percent of consumer premiums on medical care or rebate the difference to beneficiaries. Plans in the large group market must spend at least 85 percent of premiums. The rule stipulates the types of expenses that qualify for these percentages. The provision takes effect Jan. 1, 2011.
  15. White House White Board: Your Health Care Dollars | The White House
  16. Opening Statement during the Medical Loss Ratio hearing
  17. Jan. 1, 2011: Officials announce that seniors enrolled in Medicare prescription drug plans will start getting a 50 percent discount on brand-name drugs. This is the first of a series of cost reductions planned to help Medicare beneficiaries get through a coverage gap known as the doughnut hole. The law calls for the gap to be closed by 2020. 

  18. Jan. 1, 2011: Coverage of preventive care services for Medicare beneficiaries expands to include an annual wellness visit, smoking cessation counseling and free screenings for cancer, diabetes and some other chronic diseases. See related KHN story: Medicare Patients Aren't Taking Advantage Of Some Newly Free Tests

  19. March 30, 2011: Administration proposes a draft regulation on “Accountable Care Organizations.” The rule is designed to encourage hospitals, doctors and other providers to work together to coordinate patient care and save money. Providers would share in that savings. See related KHN content: New ACO Rules Outline Gains And Risks For Doctors, Hospitals or FAQ on ACOs: Accountable Care Organizations, Explained