Patient Protection and Affordable Care Act Timeline

2010

March 23, 2010 – President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. Almost immediate effects included the creation of health insurance tax credits for small businesses, the ability for young adults up to age 26 to stay on their parents’ insurance plan, provisions for free preventive care, and new coverage options for those with pre-existing conditions.

The PPACA is expected to cost $938 billion over 10 years, but because of higher taxes and fees, as well as Medicare payment cuts to health care providers, it’s projected to actually decrease the federal budget deficit by $143 billion in that same time according to the Congressional Budget Office.

2011

January 1, 2011 – Provisions kicked in which require insurance companies to spend at least 80 to 85 percent of paid premiums on providing health services, rather than using that money to cover administrative costs or keeping it for profit. If an insurance company doesn’t meet the requirements, it must issue rebates to its customers. The rebates for 2011, which were issued in summer 2012, amounted to $1.1 billion.

January 18, 2011 – Wisconsin joined 25 other states in filing suit against the PPACA in federal court, challenging the constitutionality of the bill’s “individual mandate” and Medicaid extension provisions.

January 19, 2011 – House Republicans led the first of many efforts to repeal or reduce the impact of the PPACA with the “Repeal of the Job-Killing Health Care Law Act.” None of the efforts made it past the Democrat-controlled Senate.

October 1, 2011 – Funding became available to establish an Independent Payment Advisory Board (IPAB). The IPAB will submit legislative proposals aiming to reduce the rate of growth in Medicare spending, reduce wasteful spending and medical costs, improve health outcomes for patients, and expand access to high-quality care. The board’s first recommendations are due January 15, 2014.

2012

June 28, 2012 – The Supreme Court voted 5 to 4 to uphold the majority of the PPACA, construing the penalties for not purchasing insurance under the 2014 “individual mandate” as a tax. The Supreme Court did, however, vote to allow states to opt out of the bill’s Medicaid expansion for those with low incomes, stating that pulling all Medicaid funds from states that fail to extend coverage is unduly coercive.

June 29, 2012 – Gov. Walker stated that, despite the Supreme Court decision, he would wait until after the November elections to finish implementation of certain sections of the PPACA.

July 11, 2012 – In the wake of the Supreme Court decision upholding most of the PPACA, lawmakers in the House of Representatives voted 244-185 to repeal the bill. Five Democrats, none from Wisconsin, joined Republicans in voting for the repeal. The bill was dead on arrival in the Senate. The vote marked the 33rd time the House of Representatives voted to defund, amend, or repeal the PPACA.

2014

January 1, 2014 – All health insurance plans will no longer be able to discriminate against people with pre-existing conditions or charge higher rates due to gender or health status, nor will they be able to impose annual dollar limits on the amount of coverage an individual may receive.

January 1, 2014 – Every American who can afford health coverage will have to be enrolled in an insurance plan that meets basic minimum standards. Those who do not purchase insurance may have to pay an annual fee that starts at a minimum of $95 and rises to a minimum of $695 by 2016, with a greater fee for families.

Businesses that employ 50 or more full-time employees will have to provide an affordable insurance plan for their employees or possibly pay an annual fee. It’s estimated that less than 0.2 percent of businesses would have to pay a fee.

January 1, 2014 – More health insurance tax credits become available for the middle class and small businesses that provide insurance to their employees.

Medicaid expands to include Americans who earn less than 133 percent of the poverty level, approximately $14,000 for an individual and $29,000 for a family of four. Per the Supreme Court ruling, states can opt out of the Medicaid provision, but if every state extends Medicaid coverage, 17 million currently uninsured Americans will gain insurance via the expansion.

January 1, 2014 – State-run insurance exchanges are established to create a marketplace in which individuals and small businesses can shop around for health plans. Exchanges are designed to be a one-stop shop for anyone looking to purchase insurance and drive down costs by forcing competition between providers.