Health Reform & the
Affordable Care Act

Whether you're a recent college grad, a small business owner, or a senior citizen, the new law improves your care and lowers your costs. Many of these improvements take effect this year.

To see how the law can help you, choose which category fits you:

Insurance Status:Uninsured Age:Under 26
What the Law Does for You
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year. Prior to 2014, in the case of parents with existing employer-sponsored coverage, the individual under 26 cannot have another offer of employer insurance. After 2014, this limit disappears.
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Guarantees Immediate Access to CareThe law gives immediate help to people without insurance by making coverage available through a national high-risk pool for those that have been unable to get coverage for at least six months due to a pre-existing condition. The pool begins this year.
  • Creates New Choices for Affordable Coverage. The law creates a new Health Insurance Exchange, where people without access to affordable employer-sponsored insurance or Medicaid can obtain coverage at affordable group rates. The Exchange will begin operating in 2014.
  • Provides New Tax Credits. The law provides credits to help moderate- and middle-income individuals and families pay for insurance purchased through the Exchange. These families will also be eligible for assistance in paying for co-pays and deductibles. The credits and subsidies assist people with incomes up to $43,320 for individuals and $88,200 for a family of four. The measure takes effect in 2014.
  • Expands Medicaid Coverage.The legislation expands Medicaid to cover individuals with incomes at or below 133% of the poverty level ($14,403 for an individual and $29,327 for a family of four). The measure takes effect in 2014.
Insurance Status:Uninsured Age:26-54
What the Law Does for You
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Guarantees Immediate Access to Care. The law gives immediate help to people without insurance by making coverage available through a national high-risk pool for those that have been unable to get coverage for at least six months due to a pre-existing condition. The pool begins this year.
  • Creates New Choices for Affordable Coverage. The law creates a new Health Insurance Exchange, where people without access to affordable employer-sponsored insurance or Medicaid can obtain coverage at affordable group rates. The Exchange will begin operating in 2014.
  • Provides New Tax Credits. The law provides credits to help moderate- and middle-income individuals and families pay for insurance purchased through the Exchange. These families will also be eligible for assistance in paying for co-pays and deductibles. The credits and subsidies assist people with incomes up to $43,320 for individuals and $88,200 for a family of four. The measure takes effect in 2014.
  • Expands Medicaid Coverage.The legislation expands Medicaid to cover individuals with incomes at or below 133% of the poverty level ($14,403 for an individual and $29,327 for a family of four). The measure takes effect in 2014.
Insurance Status:Uninsured Age:55-64

For most people, Medicare doesn’t begin until age 65; many older people below that age have trouble finding adequate insurance. In most states, insurance companies are allowed to charge older people more than younger people, a practice known as "age rating."

What the Law Does for You
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, limits out-of-pocket costs, and places limits on age rating.
  • Guarantees Immediate Access to Care. The law gives immediate help to people without insurance by making coverage available through a national high-risk pool for those that have been unable to get coverage for at least six months due to a pre-existing condition. The pool begins this year.
  • Creates New Choices for Affordable Coverage. The law creates a new Health Insurance Exchange, where people without access to affordable employer-sponsored insurance or Medicaid can obtain coverage at affordable group rates. The Exchange will begin operating in 2014.
  • Provides New Tax Credits. The law provides credits to help moderate- and middle-income individuals and families pay for insurance purchased through the Exchange. These families will also be eligible for assistance in paying for co-pays and deductibles. The credits and subsidies assist people with incomes up to $43,320 for individuals and $88,200 for a family of four. The measure takes effect in 2014.
  • Expands Medicaid Coverage. The legislation expands Medicaid to cover individuals with incomes at or below 133% of the poverty level ($14,403 for an individual and $29,327 for a family of four). The measure takes effect in 2014.
Insurance Status:Uninsured Age:65 and over
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage. Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund.The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care.The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:Self Age:Under 26

People who buy insurance for themselves often pay more than those who get coverage through employers. At the same time, the self-insured often get less coverage.

What the Law Does for You
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Improves Preventive Coverage.Starting this year, the law eliminates co-pays and deductibles for preventive care in new health plans. Beginning in 2014, it guarantees oral and vision benefits for children.
  • Creates New Choices for Affordable Coverage.The law creates a new Health Insurance Exchange, where people without access to affordable employer-sponsored insurance or Medicaid can obtain coverage at affordable group rates. The Exchange will begin operating in 2014.
  • Provides New Tax Credits. The law provides credits to help moderate- and middle-income individuals and families pay for insurance purchased through the Exchange. These families will also be eligible for assistance in paying for co-pays and deductibles. The credits and subsidies assist people with incomes up to $43,320 for individuals and $88,200 for a family of four. The measure takes effect in 2014.
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year. Prior to 2014, in the case of parents with existing employer-sponsored coverage, the individual under 26 cannot have another offer of employer insurance. After 2014, this limit disappears.
Insurance Status:Self Age:26-54

People who buy insurance for themselves often pay more than those who get coverage through employers. At the same time, the self-insured often get less coverage.

What the Law Does for You
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Improves Preventive Coverage. Starting this year, the law eliminates co-pays and deductibles for preventive care in new health plans. Beginning in 2014, it guarantees oral and vision benefits for children.
  • Creates New Choices for Affordable Coverage. The law creates a new Health Insurance Exchange, where people without access to affordable employer-sponsored insurance or Medicaid can obtain coverage at affordable group rates. The Exchange will begin operating in 2014.
  • Provides New Tax Credits. The law provides credits to help moderate- and middle-income individuals and families pay for insurance purchased through the Exchange. These families will also be eligible for assistance in paying for co-pays and deductibles. The credits and subsidies assist people with incomes up to $43,320 for individuals and $88,200 for a family of four. The measure takes effect in 2014.
Insurance Status:Self Age:55-64

People who buy insurance for themselves often pay more than those who get coverage through employers. At the same time, the self-insured often get less coverage.

What the Law Does for You
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Improves Preventive Coverage. Starting this year, the law eliminates co-pays and deductibles for preventive care in new health plans. Beginning in 2014, it guarantees oral and vision benefits for children.
  • Creates New Choices for Affordable Coverage. The law creates a new Health Insurance Exchange, where people without access to affordable employer-sponsored insurance or Medicaid can obtain coverage at affordable group rates. The Exchange will begin operating in 2014.
  • Provides New Tax Credits. The law provides credits to help moderate- and middle-income individuals and families pay for insurance purchased through the Exchange. These families will also be eligible for assistance in paying for co-pays and deductibles. The credits and subsidies assist people with incomes up to $43,320 for individuals and $88,200 for a family of four. The measure takes effect in 2014.
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year.
Insurance Status:Self Age:65 and over
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage. Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund.The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care.The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:
Insured by Employer (Large Company)
Age:Under 26
What the Law Does for You
  • Preserves Employer-Based Insurance. Employees who receive health insurance from their employer can keep their coverage. To provide an incentive for employers to maintain coverage, the law requires large employers who don’t provide health insurance, to make payments to the federal government if their employees use federal tax credits to buy their own insurance. This incentive begins in 2014.
  • Improves Coverage. The law improves employer-based coverage by banning lifetime and restrictive annual caps on treatment costs and by requiring health plans to spend 85% of premiums on benefits. These measures begin this year. The law also prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect this year; for adults, it takes effect in 2014. Also in 2014, the law limits out-of-pocket costs in all new plans.
  • Provides a New Level of Security. After 2013 no one will need to fear losing health insurance. A new Health Insurance Exchange will offer affordable insurance options to anyone who loses his or her employer-based insurance or whose employer-based insurance is unaffordable. The law also provides credits and subsidies to help low- and moderate-income families pay for premiums and out-of-pocket expenses.
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year. Prior to 2014, in the case of parents with existing employer-sponsored coverage, the individual under 26 cannot have another offer of employer insurance. After 2014, this limit disappears.
Insurance Status:
Insured by Employer (Large Company)
Age:26-54
What the Law Does for You
  • Preserves Employer-Based Insurance. Employees who receive health insurance from their employer can keep their coverage. To provide an incentive for employers to maintain coverage, the law requires large employers who don’t provide health insurance to make payments to the federal government if their employees use federal tax credits to buy their own insurance. This incentive begins in 2014.
  • Improves Coverage.The law improves employer-based coverage by banning lifetime and restrictive annual caps on treatment costs and by requiring health plans to spend 85% of premiums on benefits. These measures begin this year. The law also prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect this year; for adults, it takes effect in 2014. Also in 2014, the law limits out-of-pocket costs in all new plans.
  • Provides a New Level of Security. After 2013 no one will need to fear losing health insurance. A new Health Insurance Exchange will offer affordable insurance options to anyone who loses his or her employer-based insurance or whose employer-based insurance is unaffordable. The law also provides credits and subsidies to help low- and moderate-income families pay for premiums and out-of-pocket expenses.
Insurance Status:
Insured by Employer (Large Company)
Age:55-64
What the Law Does for You
  • Preserves Employer-Based Insurance. Employees who receive health insurance from their employer can keep their coverage. To provide an incentive for employers to maintain coverage, the law requires large employers who don’t provide health insurance, to make payments to the federal government if their employees use federal tax credits to buy their own insurance. This incentive begins in 2014.
  • Improves Coverage. The law improves employer-based coverage by banning lifetime and restrictive annual caps on treatment costs and by requiring health plans to spend 85% of premiums on benefits. These measures begin this year. The law also prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect this year; for adults, it takes effect in 2014. Also in 2014, the law limits out-of-pocket costs in all new plans.
  • Promotes Employer Coverage of Early Retirees. The law provides funding to employers to help cover the cost of health coverage for early retirees and their families. The purpose of this funding is to ensure that people who retire will have coverage until they become eligible for Medicare. The measure begins in this year.
  • Provides a New Level of Security. After 2013 no one will need to fear losing health insurance. A new Health Insurance Exchange will offer affordable insurance options to anyone who loses his or her employer-based insurance or whose employer-based insurance is unaffordable. The law also provides credits and subsidies to help low- and moderate-income families pay for premiums and out-of-pocket expenses.
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year. Prior to 2014, in the case of parents with existing employer-sponsored coverage, the individual under 26 cannot have another offer of employer insurance. After 2014, this limit disappears.
Insurance Status:
Insured by Employer (Large Company)
Age:65 and over
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage. Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund.The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care.The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:
Insured by Employer (Small Business)
Age:Under 26

Small businesses often pay more than large businesses for comparable health insurance. These costs are often passed on to small business employees, in the form of higher premiums or lower wages.

What the Law Does for You
  • Makes Insurance More Affordable. Starting this year, the law provides a tax credit to help many small businesses pay for coverage for their employees. In 2014, the law allows small businesses to purchase coverage through a new Health Insurance Exchange at affordable rates.
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Provides a New Level of Security. After 2013 no one will need to fear losing health insurance. A new Health Insurance Exchange will offer affordable insurance options to anyone who loses his or her employer-based insurance or whose employer-based insurance is unaffordable. The law also provides credits and subsidies to help low- and moderate-income families pay for premiums and out-of-pocket expenses.
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year. Prior to 2014, in the case of parents with existing employer-sponsored coverage, the individual under 26 cannot have another offer of employer insurance. After 2014, this limit disappears.
Insurance Status:
Insured by Employer (Small Business)
Age:26-54

Small businesses often pay more than large businesses for comparable health insurance. These costs are passed on to small business employees, in the form of higher premiums or lower wages.

What the Law Does for You
  • Makes Insurance More Affordable. Starting this year, the law provides a tax credit to help many small businesses pay for coverage for their employees. In 2014, the law allows small businesses to purchase coverage through a new Health Insurance Exchange at affordable rates.
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, and limits out-of-pocket costs.
  • Provides a New Level of Security. After 2013 no one will need to fear losing health insurance. A new Health Insurance Exchange will offer affordable insurance options to anyone who loses his or her employer-based insurance or whose employer-based insurance is unaffordable. The law also provides credits and subsidies to help low- and moderate-income families pay for premiums and out-of-pocket expenses.
Insurance Status:
Insured by Employer (Small Business)
Age:55-64

Small businesses often pay more than large businesses for comparable health insurance. These costs are often passed on to small business employees, in the form of higher premiums or lower wages.

What the Law Does for You
  • Makes Insurance More Affordable. Starting this year, the law provides a tax credit to help many small businesses pay for coverage for their employees. In 2014, the law allows small businesses to purchase coverage through a new Health Insurance Exchange at affordable rates.
  • Implements Insurance Market Reforms. The law prohibits health plans from excluding coverage on the basis of pre-existing conditions. For children, the measure takes effect in September; for adults, it takes effect in 2014. Starting this year, the law also bans lifetime and restrictive annual caps on treatment costs. Starting in 2014, it bars insurers from charging women and sicker individuals higher rates, limits out-of-pocket costs, and sets limits on the amount an insurance company can charge based on age.
  • Provides a New Level of Security. After 2013 no one will need to fear losing health insurance. A new Health Insurance Exchange will offer affordable insurance options to anyone who loses his or her employer-based insurance or whose employer-based insurance is unaffordable. The law also provides credits and subsidies to help low- and moderate-income families pay for premiums and out-of-pocket expenses.
  • Allows Coverage on Parents’ Policies. The law provides that individuals under the age of 26 who don’t have insurance can receive coverage through their parents’ plan. The measure takes effect this year. Prior to 2014, in the case of parents with existing employer-sponsored coverage, the individual under 26 cannot have another offer of employer insurance. After 2014, this limit disappears.
Insurance Status:
Insured by Employer (Small Business)
Age:65 and over
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage. Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund.The reforms in the law extend the solvency of the Medicare Trust Fund for 12years, helping to meet the program’s commitments in the future.
  • • Improves Nursing Home Care.The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:Insured by Medicaid Age:Under 26
What the Law Does for You
  • Expands Medicaid Coverage. The legislation expands Medicaid coverage to individuals and households with incomes below 133% of the federal poverty level, which is $14,403 for an individual and $29,327 for a family of four. For the first time, low-income adults who do not have dependent children would be eligible for Medicaid. The measure takes effect in 2014.
  • Coverage of Low-income Children. The law provides assistance for covering children in low-income families through Medicaid, the Children’s Health Insurance Program (CHIP), or tax credits in the new Health Insurance Exchange. Through 2015, the law maintains CHIP, offering insurance to millions of low-income children who are not covered through Medicaid or a parent’s employer. After 2015, children in the CHIP program will either be covered by Medicaid or receive financial assistance for coverage through the Exchange.
  • Improves Medicaid Primary Care Payments. In 2013 and 2014, the law will enhance primary care by increasing the amount that Medicaid pays to primary care doctors, ensuring that more doctors offer such services.
Insurance Status:Insured by Medicaid Age:26-54
What the Law Does for You
  • Expands Medicaid Coverage. The legislation expands Medicaid coverage to individuals and households with incomes below 133% of the federal poverty level, which is $14,403 for an individual and $29,327 for a family of four. For the first time, low-income adults who do not have dependent children would be eligible for Medicaid. The measure takes effect in 2014.
  • Coverage of Low-income Children. The law provides assistance for covering children in low-income families through Medicaid, the Children’s Health Insurance Program (CHIP), or tax credits in the new Health Insurance Exchange. Through 2015, the law maintains CHIP, offering insurance to millions of low-income children who are not covered through Medicaid or a parent’s employer. After 2015, children in the CHIP program will either be covered by Medicaid or receive financial assistance for coverage through the Exchange.
  • Improves Medicaid Primary Care Payments. In 2013 and 2014, the law will enhance primary care by increasing the amount that Medicaid pays to primary care doctors, ensuring that more doctors offer such services.
Insurance Status:Insured by Medicaid Age:55-64
What the Law Does for You
  • Expands Medicaid Coverage. The legislation expands Medicaid coverage to individuals and households with incomes below 133% of the federal poverty level, which is $14,403 for an individual and $29,327 for a family of four. For the first time, low-income adults who do not have dependent children would be eligible for Medicaid. The measure takes effect in 2014.
  • Coverage of Low-income Children. The law provides assistance for covering children in low-income families through Medicaid, the Children’s Health Insurance Program (CHIP), or tax credits in the new Health Insurance Exchange. Through 2015, the law maintains CHIP, offering insurance to millions of low-income children who are not covered through Medicaid or a parent’s employer. After 2015, children in the CHIP program will either be covered by Medicaid or receive financial assistance for coverage through the Exchange.
  • Improves Medicaid Primary Care Payments. In 2013 and 2014, the law will enhance primary care by increasing the amount that Medicaid pays to primary care doctors, ensuring that more doctors offer such services.
Insurance Status:Insured by Medicaid Age:65 and over
What the Law Does for You
  • Expands Medicaid Coverage. The legislation expands Medicaid coverage to individuals and households with incomes below 133% of the federal poverty level, which is $14,403 for an individual and $29,327 for a family of four. For the first time, low-income adults who do not have dependent children would be eligible for Medicaid. The measure takes effect in 2014.
  • Coverage of Low-income Children. The law provides assistance for covering children in low-income families through Medicaid, the Children’s Health Insurance Program (CHIP), or tax credits in the new Health Insurance Exchange. Through 2015, the law maintains CHIP, offering insurance to millions of low-income children who are not covered through Medicaid or a parent’s employer. After 2015, children in the CHIP program will either be covered by Medicaid or receive financial assistance for coverage through the Exchange.
  • Improves Medicaid Primary Care Payments. In 2013 and 2014, the law will enhance primary care by increasing the amount that Medicaid pays to primary care doctors, ensuring that more doctors offer such services.
Insurance Status:Insured by Medicare Age:Under 26
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage.Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund. The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care. The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:Insured by Medicare Age:26-54
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage.Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund. The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care. The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:Insured by Medicare Age:55-64
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage.Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund. The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care. The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:Insured by Medicare Age:65 and over
What the Law Does for You
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage.Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund. The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care. The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Insurance Status:Other Age:Under 26
What the Law Does for You
  • Preserves Current Insurance for Veterans, Soldiers, and Others.Veterans receive health coverage through the VA and members of the Armed Forces receive health coverage through TRICARE. The law does not change this coverage. The law also does not affect coverage for people insured by the Federal Employees Health Benefits Program.
  • Provides Additional Insurance Options. The law allows veterans and members of the Armed Forces to enroll in coverage through the new Health Insurance Exchange, which begins in 2014. This provides veterans and service members the chance to get additional coverage if they want it.
Insurance Status:Other Age:26-54
What the Law Does for You
  • Preserves Current Insurance for Veterans, Soldiers, and Others.Veterans receive health coverage through the VA and members of the Armed Forces receive health coverage through TRICARE. The law does not change this coverage. The law also does not affect coverage for people insured by the Federal Employees Health Benefits Program.
  • Provides Additional Insurance Options. The law allows veterans and members of the Armed Forces to enroll in coverage through the new Health Insurance Exchange, which begins in 2014. This provides veterans and service members the chance to get additional coverage if they want it.
Insurance Status:Other Age:55-64
What the Law Does for You
  • Preserves Current Insurance for Veterans, Soldiers, and Others. Veterans receive health coverage through the VA and members of the Armed Forces receive health coverage through TRICARE. The law does not change this coverage. The law also does not affect coverage for people insured by state health plans and the Federal Employees Health Benefits Program.
  • Provides Additional Insurance Options. The law allows veterans and members of the Armed Forces to enroll in coverage through the new Health Insurance Exchange, which begins in 2014. This provides veterans and service members the chance to get additional coverage if they want it.
Insurance Status:Other Age:65 and over
What the Law Does for You
  • Preserves Current Insurance for Veterans, Soldiers, and Others. Veterans receive health coverage through the VA and members of the Armed Forces receive health coverage through TRICARE. The law does not change this coverage. The law also does not affect coverage for people insured by the Federal Employees Health Benefits Program.
  • Protects and Strengthens Medicare. Virtually all U.S. citizens who are 65 or over or permanently disabled are covered by, or eligible for, Medicare. The law does not change this. And it does not cut guaranteed Medicare benefits.
  • Closes the Part D Donut Hole. Medicare beneficiaries enrolled in the Part D program now pay 100% of the costs for all drug costs between $2,700 and $6,200. Beginning this year, the law significantly reduces these out-of-pocket costs. In 2010, it provides a $250 rebate for beneficiaries in the donut hole; in 2011, it requires manufacturers to provide 50% discounts for brand-name drugs to beneficiaries when they hit the donut hole; and over the next decade, it completely closes the donut hole.
  • Improves Preventive Coverage.Starting in 2011, the law saves Medicare beneficiaries money by fully covering all co-pays for a wide range of tests and procedures, including mammograms, colonoscopies, and tests for many chronic diseases.
  • Strengthens the Medicare Trust Fund. The reforms in the law extend the solvency of the Medicare Trust Fund for 12 years, helping to meet the program’s commitments in the future.
  • Improves Nursing Home Care. The law makes nursing homes better by improving staff training, providing more information to families and residents about quality of care, and giving Medicare new tools to improve nursing homes that fail to provide a high level of care.
Committee on Energy & Commerce