This timeline shows when some aspects of the health reform law that affect states must be or have been implemented.
â†’Requires the federal government to create a process, with states, where insurers must justify unreasonable premium increases. Provides grants to states for reviewing premium increases.
â†’Creates a state option to provide Medicaid coverage to childless adults with incomes up to 133 percent of the federal poverty level. (States will be required to provide this coverage in 2014.)
â†’Creates a temporary program to provide health coverage to individuals with pre-existing medical conditions who have been uninsured for at least six months. The plan will be operated by the states or the federal government.
â†’Provides states with new options for offering home- and community-based services through a Medicaid state plan amendment, and permits states to extend full Medicaid benefits to individuals receiving home and community-based services under a state plan.
â†’Creates a new Medicaid state option to let certain Medicaid enrollees designate a provider as a health home and provides states taking up the option 90 percent federal matching payments for two years for health home-related services.
â†’Provides three-year grants to states to develop programs to provide Medicaid enrollees with incentives to participate in comprehensive health lifestyle programs and meet certain health behavior targets.
â†’Authorizes $50 million for five-year demonstration grants to states to develop, implement and evaluate alternatives to current tort litigations.
â†’Provides grants to states to begin planning for the establishment of health insurance exchanges, which facilitate the purchase of insurance by individuals and small employers.
â†’Creates new demonstration projects in Medicaid for up to eight states to pay bundled payments for episodes of care that include hospitalizations and to allow pediatric medical providers organized as accountable care organizations to share in cost-savings.
â†’Increases Medicaid payments for primary care services provided by primary care doctors to 100 percent of the Medicare payment rate for 2013 and 2014, paid with federal funding.
â†’Creates state-based health insurance exchanges, administered by a governmental agency or nonprofit organization, through which individuals and small businesses with up to 100 employees can purchase qualified coverage.
â†’Requires U.S. citizens and legal residents to have qualifying health coverage (there is a phased-in tax penalty for those without coverage, with certain exemptions).
â†’Expands Medicaid to all individuals not eligible for Medicare under age 65 with incomes up to 133 percent of the poverty level and provides enhanced federal matching payments for new eligibles.
â†’Permits states to form health care choice compacts and allows insurers to sell policies in any state participating in the compact.
SOURCE: Kaiser Family Foundation