2014 Major Provisions - PPACA

Implement individual health insurance and employer responsibility requirements

• Implementation date: January 1, 2014

Create state-based health insurance exchanges and provide choice through multi-state plan

• Implementation date: January 1, 2014

Require guaranteed issue and limited rating restrictions

• Implementation date: January 1, 2014

Create essential benefits package and require its use in all qualified plans

• Implementation date: January 1, 2014

Provide refundable and advanceable tax credits to individuals and families (income 133-400% FPL)

• Implementation date: January 1, 2014

Expand small business tax credits

• Implementation date: January 1, 2014

Prohibit all pre-existing condition exclusions

• Implementation date: January 1, 2014

Eliminate all lifetime limit caps for essential benefits

• Implementation date: January 1, 2014

Expand Medicaid to patients <65 with incomes up to 133% FPL

• Implementation date: January 1, 2014

Establish Independent Payment Advisory Board (IPAB) tasked with developing comprehensive proposals to reduce excess cost growth and improve care quality in Medicare

• Implementation date: First recommendations due January 15, 2014, (funding available October 1, 2011)

Reduce Medicare Disproportionate Share Hospital payments

• Implementation date: October 1, 2014

Adopt single set of operating rules health claims or equivalent encounter information, enrollment and disenrollment in a health plan, health plan premium payments, and referral certification and authorization

• Implementation date: Rules adopted July 1, 2014; effective January 1, 2016.