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The Affordable Care Act Timeline

The Affordable Care Act (ACA) was a historic milestone in our fight for a more equitable and cost-effective health care system. The law already is helping families, and more help is on the way. Here is a timeline of changes under the law.

When President Obama Signed the Law in March 2010

Provided tax credits for small businesses to cover employees, a $250 rebate for seniors who reach the Medicare prescription “donut hole” and coverage for pre-existing conditions.

March 2010

Barred insurance companies from refusing to cover children with pre-existing conditions and from dropping coverage for people who get sick and placing lifetime limits on coverage. It also allowed children to stay on their parents’ policies until age 26.

Thank You for Health Care Reform

At the U.S. Capitol March 21, 2010, for the historic health care vote in the House.

In 2010

Placed new rules on premium increases and gave consumer new rights to appeal insurance company decisions.

In 2011

Required insurance companies to spend 80 percent to 85 percent of premiums on medical care; provided free preventive care under Medicare and half-priced brand-name prescription drugs for seniors in the Medicare “donut hole;” provided grants for employee wellness programs and help for employers offering coverage for early retirees.

Jan. 1, 2012

Accountable Care Organizations: The new law provides incentives for physicians to join together to form “Accountable Care Organizations.” In these groups, doctors can better coordinate patient care and improve the quality, help prevent disease and illness and reduce unnecessary hospital admissions. Learn more about Accountable Care Organizations.

March 2012

Addressing Health Disparities:  Health programs must report racial, ethnic and language data to help identify and reduce disparities. Learn more about health disparities and the Affordable Care Act.

Oct. 1, 2012

Electronic Recordkeeping:  To reduce paperwork, costs and medical errors, billing will be standardized and health plans will begin adopting rules for the secure electronic exchange of health information. Learn how the law improves the health care system for providers, professionals, and patients.

Value-Based Purchasing: This program offers financial incentives to hospitals to improve the quality of care.

Jan. 1, 2013

Preventive Health Care: To expand preventive care, the law provides new funding to state Medicaid programs that choose to cover preventive services for patients at little or no cost.

Increasing Medicaid Payments: As Medicaid programs and providers prepare to cover more patients in 2014, the act requires states to pay primary care physicians at least the full Medicare payment rates for primary care services. Learn how the law supports and strengthens primary care providers.

‘Bundling’ Payments:  A national pilot program paying providers flat fees for an episode of care will attempt to encourage hospitals, doctors and other providers to work together to improve the coordination and quality of patient care and reduce costs.

Oct. 1, 2013

Children’s Health: Under the new law, states will receive two more years of funding to continue coverage for children not eligible for Medicaid. Learn more about CHIP.

Jan. 1, 2014

Affordable Insurance Exchanges: Starting in 2014, if your employer doesn’t offer insurance, you will be able to buy it directly in an Affordable Insurance Exchange. An exchange is a new insurance marketplace where individuals and small businesses can buy health plans that meet benefits and cost standards. Members of Congress will be getting their health care insurance through exchanges, too. Learn more about Affordable Insurance Exchanges.

Individual Responsibility:  Most people who can afford it will be required to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for the uninsured Americans. Learn more about individual responsibility and the law.

Choice of Coverage: Some workers who can’t afford their employer’s coverage will get help buying coverage through the exchanges.

Expanding Access to Medicaid: Low-income individuals and families will be eligible to enroll in Medicaid and states choosing to adopt the expansion will get federal financing to cover almost all the costs of coverage for newly eligible individuals and families. Learn more about Medicaid.

Making Coverage Affordable: Tax credits will help the middle class afford insurance if they are not eligible for other affordable coverage. People may also qualify for reduced cost-sharing. Learn how the law will make care more affordable in 2014.

Ending Annual Coverage Limits: The law prohibits new plans and existing group plans from imposing annual dollar limits on coverage. Learn how the law will phase out annual limits by 2014.

Ending Discrimination:  Insurance companies will be prohibited from refusing to sell or renew coverage because of pre-existing conditions, and from charging more because of gender or health status. Learn more about protecting Americans with pre-existing conditions.

Increasing Small Business Tax Credit: The small business tax credit is raised and there is also a % credit for small nonprofit organizations. Learn more about the small business tax credit.

Jan. 1, 2015

Tying Payments to Value:  Physician payments will be tied to the quality of care they provide.

Sources: 2011 AFL-CIO Legislative Guide;

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