The Affordable Care Act Timeline
The Affordable Care Act doesn’t go into effect overnight. While some key provisions have already taken effect, other changes will be phased in gradually through 2014 and beyond. Year by year, this timeline shows you what’s happening when.
March 23: President Obama signs the Affordable Care Act, a set of comprehensive health insurance reforms.
April 1: States can receive Federal matching funds to cover additional low-income individuals and families.
July 1: A temporary Pre-Existing Condition Insurance Plan provides coverage options for people who have been uninsured for at least 6 months because of pre-existing conditions.
September 23: The following are in effect (for health plan years beginning on or after this date):
- Young adults can stay on their parents’ plans until they turn 26.
- Insurers can no longer deny coverage to children under 19 because of pre-existing conditions.
- Plans must cover certain preventive services without requiring copayments or deductibles.
- Insurance companies can no longer impose lifetime limits on essential benefits and face new restrictions on annual limits.
- Insurance companies’ use of annual dollar limits on coverage is restricted for new plans in the individual market and in all group plans.
- Insurance companies can no longer use innocent errors on customers’ applications to deny payment for services when customers get sick.
October: All state Medicaid programs must cover smoking cessation programs for pregnant women. States gain more flexibility in offering home- and community-based services under Medicaid.
A new $15 billion Prevention and Public Health Fund begins investing in proven prevention and public health programs, such as smoking cessation and combating obesity.
New funding will support the construction and expansion of services at community health centers, allowing them to serve 20 million new patients.
January: States can opt to receive enhanced Federal funding to support health homes to coordinate care of persons with chronic illnesses, including those with mental and substance use disorders.
October 11: A new Community First Choice Option allows states to offer home- and community-based services to people with disabilities via Medicaid rather than institutional care in nursing homes.
January 1: Physicians receive incentives for coming together in “Accountable Care Organizations” to better coordinate care, improve quality, prevent disease, and reduce unnecessary hospitalizations.
January 1: States receive new funding to cover preventive services for Medicaid patients at little or no cost.
- Individuals whose employers don’t offer insurance can buy insurance directly in an exchange—a new competitive marketplace for individuals and small businesses to buy affordable health plans.
- Americans who earn less than 133 percent of the poverty level can enroll in Medicaid; states will receive 100 percent Federal funding for the first 3 years and 90 percent in subsequent years to support this expanded coverage.
- Tax credits to make it easier for the middle class to afford insurance become available for people with incomes above 100 percent and below 400 percent of the poverty level who aren’t eligible for or offered other affordable coverage.
- New plans and existing group plans may no longer impose annual limits on coverage (including hospital stays and other essential benefits).
- Insurance companies can no longer refuse to sell coverage or renew policies because of pre-existing conditions; they can also no longer charge higher rates because of health status or gender.
Find more information on the health care reform timeline.