Friday, April 2, 2010

Timetable Highlights for Universal Healthcare

2010
•States and Federal officials review premium increases
•Medicare payments to physicians in primarily rural areas increase (2 years)
•Impose 10% tax on indoor UV tanning (7/1/10)
•Medicare cuts to inpatient psych hospitals (7/1/10)
•Requires plans to cover, at no charge, most preventive care (plan years beginning
9/23/10)
•Allows dependents to stay on parents’ policies through age 26 (plan years
beginning 9/23/10)
•Provides limited protections to children with pre‐existing conditions (plan years
beginning 9/23/10)
•Hospitals in "Frontier States" (ND, MT, WY, SD, UT ) receive higher Medicare
payments (FY11)
•Hospitals in “low‐cost” areas receive higher Medicare payments for 2 yrs ($400
million, FY11)

2011
•Medicare Advantage cuts begin
•Medicare cuts to home health begin
•Wealthier seniors ($85k/$170k) begin paying higher Part D premiums (not indexed
for inflation in Parts B/D)
•Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT
scans, etc.
•Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable
medical equipment
•Americans begin paying premiums for federal long‐term care insurance (CLASS Act)
•Physicians in "Frontier States" (ND, MT, WY, SD, UT ) receive higher Medicare
payments
•Seniors prohibited from purchasing power wheelchairs unless they first rent for 13
months
•Brand name drug companies begin providing 50% discount in the Part D “donut
hole”
•Seniors who hit Part D “donut hole "in 2010 receive $250 check (3/15/11)
•New Medicare cuts to long‐term care hospitals begin (7/1/11)
•Additional Medicare cuts to hospitals and cuts to nursing homes and inpatient
rehab facilities begin (FY12)

2012
•Medicare cuts to dialysis treatment begins
•New Medicare cuts to inpatient psych hospitals (7/1/12)
•Medicare cuts to hospitals with high readmission rates begin (FY13)
•Medicare cuts to hospice begin (FY13)


2013
•Impose $2,500 annual cap on FSA contributions (indexed to CPI)
•Increase Medicare wage tax by 0.9% and impose a new 3.8% tax on unearned , nonactive
business income for those earning over $200k/$250k (not indexed to inflation)
•Generally increases (7.5% to 10%) threshold at which medical expenses, as a % of
income, can be deductible
•Eliminate deduction for Part D retiree drug subsidy employers receive
•Impose 2.3% excise tax on medical devices
•Medicare cuts to hospitals who treat low‐income seniors begin
•Part D “donut hole” reduction begins, reaching a 25% reduction by 2020


2014
•Individuals without gov't‐approved coverage are subject to a tax of the greater of
$695 or 2.5% of income
•Employers who fail to offer "affordable" coverage would pay a $3,000 penalty for
every employee that receives a subsidy through the Exchange
•Employers who do not offer insurance must pay a tax penalty of $2,000 for every fulltime
employee
•More Medicare cuts to home health begin
•Employers with more than 200 employees can auto‐enroll employees in health
coverage, with opt‐out
•States must cover parents /childless adults up to 138% of poverty on Medicaid,
receive increased FMAP
•Tax credits available for Exchange‐based coverage, amount varies by income up to
400% of poverty
•Insurers cannot impose any coverage restrictions on pre‐existing conditions
(guaranteed issue/renewability)
•Insurers must offer coverage to anyone wanting a policy and every policy has to be
renewed
•Government board (IPAB) begins submitting proposals to cut Medicare
•Impose tax on nearly all private health insurance plans
•Medicare payment cuts for hospital‐acquired infections begin (FY15)

2015
More Medicare cuts to home health begin

2016
•States can form interstate insurance compacts if the coverage with HHS approval (2016)

2018
•Impose "Cadillac tax on “high cost” plans, 40% tax on the benefit value above a certain
threshold: ($10,200 individual coverage, $27,500 family or self‐only union multiemployer
coverage)