Affordable Care Act information center

Implementation of the Patient Protection and Affordable Care Act, Obama Care or Healthcare Reform (PPACA), whatever you want to call it, has forced Americans to rethink health insurance. Whether you are an employer or employee, the PPACA affects you.

Additional resources

OSBA offers a toolkit which includes spreadsheets to help you with ACA calculations.

Implementation timeline

March 23, 2010: President Obama signs the Affordable Care Act

  • Coverage for Children with Pre-existing Conditions
  • Coverage for Children Up to Age 26
  • Lifetime Limits on Coverage Prohibited [ACA Dollar Limits]
  • Annual Limits Restricted [ACA Dollar Limits]
  • No Arbitrary Cancellations or Rescissions of Coverage
  • Small Employer Tax Credit
  • Community Health Centers
  • Access to OB/GYN Without Referral [Grandfathering Q&A; Preventive Services-Women}
  • Must Provide Direct Access to or Coverage for Emergency Services [Grandfathering Q&A]
  • Must Cover Preventative Care Without Cost-Sharing [Grandfathering Q&A; Preventive Services-Women; Preventive Services-Adults; Preventive Services-Children]
  • Must Allow Individuals to Choose Their PCPs/Pediatricians [Grandfathering Q&A]
  • Must Follow New Internal and External Review Standards [Grandfathering Q&A]
  • Insured Plans May Not Discriminate in Favor of Highly Compensated [Grandfathering Q&A]
  • Tax on Indoor Tanning Services
  • Review of Health Plan Premium Increases
  • Changes in Medicare Provider Rates
  • Medicaid and CHIP Payment Advisory Commission [Glossary]
  • Medicaid Coverage for Childless Adults
  • Medicaid Community-Based Services
  • Comparative Effectiveness Research (CER/PCORI)
  • Prevention and Public Health Fund
  • Generic Biologic Drugs
  • Consumer Website
  • Expansion of Drug Discount Program
  • Consumer Protections in Insurance
  • Health Care Workforce Commission


  • Funding for Health Insurance Exchanges
  • OTC Drugs Only Reimbursed with Prescription [OTC Q&A]
  • Tax of Prescription Drug Manufacturers (potential to increase employer costs)
  • HSA Penalty Increased for Non-qualified Distributions [OTC Q&A]
  • Changes to Tax-Free Savings Accounts
  • The 80/20 Rule (Medical Loss Ratio) [Glossary]
  • Rate Review
  • Small Employer Wellness Grants
  • Patient Outcome Comparative Effectiveness Research Institute (CER/PCORI) Fee
  • W-2 reporting for Employers Who Sponsor Health Coverage and File 250+ W-2s [W-2 Q&A]
  • Medicare Payments for Primary Care
  • Center for Medicare and Medicaid Innovation
  • Free Medicare Preventive Services for Seniors
  • Prescription Drug Discounts for Seniors [Closing the Medicare Drug Coverage Gap (Doughnut hole)]
  • Medicare Premiums for Higher Income Beneficiaries
  • Medicare Advantage Payment Changes
  • Medicaid Health Homes
  • Medicaid Long-Term Care Services
  • Medicaid Payments for Hospital-Acquired Infections
  • Chronic Disease Prevention in Medicaid
  • Medical Malpractice Grants
  • Graduate Medical Education
  • Required Nutritional Labeling


  • New Preventive Services for Women [Preventive Services-Women]
  • Summary of Benefits and Coverage and the Uniform Glossary
  • 60-Day Advance Notice of Mid-Year Benefit Changes required
  • Medical Device Fee (potential to increase employer costs)
  • Accountable Care Organizations in Medicare
  • Medicare Advantage Plan Payments
  • Medicare Provider Payment Changes
  • Medicaid Payment Demonstration Projects
  • Data Collection to Reduce Health Care disparities
  • Medicare Value-Based Purchasing
  • Reduced Medicare Payment for Hospital Readmissions
  • Annual Fees on the Pharmaceutical Industry


  • October 1: Open enrollment in the Health Insurance Marketplace began for certain individuals
  • W-2 reporting for employers who sponsor health coverage and file less than 250 W-2s [W-2 Q&A]
  • Health FSA contributions limited [Bargaining FAQ]
  • Employee education for new hires
  • CER (PCORI) Fee due by July 31st each year
  • State Notification Regarding Exchanges
  • Medicare Bundled Payment Pilot Program
  • Medicaid Payments for Primary Care
  • Medicaid Coverage of Preventive Services
  • Medicare Disproportionate Share Hospital Payments
  • Medicaid Disproportionate Share Hospital Payments
  • Medicare Tax Increase
  • Itemized Deductions for Medical Expenses
  • Financial Disclosure
  • CO-OP Health Insurance Plans
  • Extension of CHIP [Glossary]


  • January 1: Coverage Begins in the Health Insurance Marketplace (Cover Oregon)
  • Employer Shared Responsibility Payment Due (Free Rider Penalty) DELAYED [ACA Summary; Employer Shared Responsibility]
  • Coverage for Pre-existing Conditions
  • Savings on Monthly Premiums and Out-Of-Pocket Costs
  • No More Yearly Limits On Coverage [Excise Tax Q&A; ACA Dollar Limits]
  • Expanded small business tax credit
  • March 31: Open enrollment closes (unless you have already started the application process)
  • Mandate for Individual Insurance [Bargaining FAQ]
  • Guaranteed Availability of Insurance [ACA Summary; Bargaining FAQ]
  • Essential Health Benefits [ACA Summary]
  • Multi-State Health Plans
  • Temporary Reinsurance Program for Health Plans
  • Basic Health Plan
  • Medicaid Expansion
  • Medicare Payments for Hospital-Acquired Infections
  • Medicare Advantage Plan Loss Ratios
  • Wellness Programs in Insurance Increases to 30%
  • Fees on Health Insurance Sector





For more information contact Peggy Stock at 800-578-6722 or via e-mail at