Key Near-Term Provisions

Key provisions of the health care reform law taking effect in 2013 and later

Key provisions beginning in 2013

  • Contributions to FSAs limited to $2,500 annually, effective for plan years beginning on or after Jan. 1, 2013.
  • Other 2013 provisions:
    • New tax on high-income individuals.
    • New tax on medical device manufacturers.
    • Phased-in reductions in out-of-pocket maximums paid by Medicare Part D beneficiaries.

Key provisions beginning in 2014

  • Availability of insurance exchanges in each state that will serve as a marketplace in which individuals and small employer groups can purchase health care coverage.
  • Guaranteed issue of medical coverage.
  • Pre-existing condition limitations prohibited for adults (prohibition on pre-existing condition limitations on children go into effect for plan years on or after Sept. 23, 2010).
  • Individuals will be required to have medical coverage or face a penalty.
  • Employers with 50 or more employees required to pay a fee for employees who receive premium subsidies to purchase coverage through the exchange.
  • Waiting periods for health coverage limited to no more than 90 days (effective for plan years beginning on or after Jan. 1, 2014).

Key provisions beginning after 2014

  • 2017: Each state determines whether it will allow larger employer group health plans (those with 101 employees or more) to purchase health insurance coverage through an Exchange.
  • 2018: New tax on high-cost plans (a.k.a., “Cadillac plans”).

—Read about key provisions already in effect

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