• President Lyndon B. Johnson signs the Social Security Act, which authorizes both Medicare and Medicaid; the law is widely labeled the biggest healthcare reform of the past century.
• President Bill Clinton attempts to craft universal healthcare legislation that includes both individual and employer mandates. He appoints his wife, Hillary Rodham Clinton, as chair of the White House Task Force on Health Reform. The President’s Health Security Act ultimately fails in Congress.
• State Children’s Health Insurance Program (S-CHIP) authorized by Congress, covering low-income children in families above Medicaid eligibility levels.
• Massachusetts (followed by Vermont in 2011) passes legislation that expands healthcare coverage to nearly all state residents; the Massachusetts law is later deemed a template for the Patient Protection and Affordable Care Act of 2010.
The Patient Protection and Affordable Care Act (ACA)
March 23, 2010
• President Obama signs the ACA into law. Among the law’s early provisions: Medicare beneficiaries who reach the Part D drug coverage gap begin receiving $250 rebates, and the IRS begins allowing tax credits to small employers that offer health insurance to their employees.
July 1, 2010
• Federal government begins enrolling patients with pre-existing conditions in a temporary Pre-Existing Condition Insurance Plan (PCIP).
• Healthcare.gov website debuts.
• IRS begins assessing 10% tax on indoor tanning.
Sep. 23, 2010
• Patient-Centered Outcomes Research Institute (PCORI) launches with 21-member board of directors.
• For new insurance plans or those renewed on or after this date, parents are allowed to keep adult children on their health policies until they turn 26 (many private plans voluntarily offered this option earlier).
• HHS bans insurers from imposing lifetime coverage limits and from denying health coverage to children with pre-existing conditions or excluding specific conditions from coverage.
• HHS requires new and renewing health plans to eliminate cost sharing for certain preventive services recommended by U.S. Preventive Services Task Force.
Sep. 30, 2010
• U.S. Comptroller General appoints 15 members to National Health Care Workforce Commission (commission does not secure funding).
December 30, 2010
• Medicare debuts first phase of Physician Compare website.
Jan. 1, 2011
• CMS begins closing Medicare Part D drug coverage gap.
• Medicare begins paying 10% bonus for primary care services (funded through 2015).
• Center for Medicare and Medicaid Innovation debuts, with a focus on testing new payment and care delivery systems.
March 23, 2011
• HHS begins providing grants to individual states to help set up health insurance exchanges.
July 1, 2011
• CMS stops paying for Medicaid services related to specific hospital-acquired infections.
Oct. 1, 2011
• Fifteen-member Independent Payment Advisory Board is formally established (but no members are nominated). The IPAB is charged with issuing legislative recommendations to lower Medicare spending growth, but only if projected costs exceed a certain threshold.
Jan. 1, 2012
• CMS launches Medicaid bundled-payment demonstration and Accountable Care Organization (ACO) incentive program.
• CMS reduces Medicare Advantage rebates but offers bonuses to high-quality plans.
Aug. 1, 2012
• HHS requires most new and renewing health plans to eliminate cost sharing for women’s preventive health services, including contraception.
Oct. 1, 2012
• CMS begins its Value-Based Purchasing (VBP) Program in Medicare, starting with a 1% withholding in FY2013.
• CMS begins reducing Medicare payments based on excess hospital readmissions, starting with a 1% penalty in FY2013.