Health Care Overhaul: When and How It Will Affect You (Part 2)

Health Care Overhaul: When and How It Will Affect You (Part 2)

The following is from a timeline of implementation dates produced by the Henry J. Kaiser Family Foundation for when some of the key provisions of the Patient Protection and Affordable Healthcare Act will take effect. This is a continuation of last week’s newsletter, which outlined the changes from the years 2010 through 2013:


Individual and Employer Requirements:

  • Require U.S. citizens and legal residents to have qualifying health coverage (phase-in tax penalty for those without coverage).
  • Assess employers with more than 50 employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit a fee of $2000 per full-time employee, excluding the first 30 employees from the assessment.

Insurance Reforms:

  • Create state-based American Health Benefit Exchanges and Small Business Health Options Program (SHOP) Exchanges, administered by a government agency or non-profit organization, through which individuals and small businesses with up to 100 employees can purchase qualified coverage.
  • Limit any waiting periods for coverage to 90 days.

Premium Subsidies:

  • Provide refundable and advanceable premium credits and cost sharing subsidies to eligible individuals and families with incomes between 133-400% FPL to purchase insurance through the Exchanges.


  • Reduce the out-of-pocket amount that qualifies an enrollee for catastrophic coverage in Medicare Part D (effective through 2019).
  • Require Medicare Advantage plans to have medical loss ratios no lower than 85%.

2015 and later

Tax Changes:

  • Impose an excise tax on insurers of employer-sponsored health plans with aggregate values that exceed $10,200 for individual coverage and $27,500 for family coverage (Effective January 1, 2018). 

The attorneys at Oast & Hook, P.C., are currently studying the Act in order to better incorporate its provisions into estate and long-term care planning for clients to ensure clients don’t run out of money during retirement.

For more information on the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, visit the following websites:

Oast & Hook, P.C.:

Henry J. Kaiser Family Foundation:

U.S. Department of Health and Human Services:

Oast & Hook has been providing quality legal services in Southeastern Virginia and North Carolina for more than 80 years. The attorneys at Oast & Hook can assist clients with their estate, financial, insurance, long-term care, veterans' benefits and special needs planning issues. Visit their website at for more information.

Sandra Smith

Sandra L. Smith joined the firm in 2003. She practices primarily in the areas of elder law, estate planning, estate and trust administration, special needs planning, asset protection planning, long-term care planning and Veterans' benefits. Ms. Smith is certified as an Elder Law Attorney (CELA) by The National Elder Law Foundation (NELF).

In 2008, Ms. Smith was named as a Rising Star by Virginia Super Lawyers magazine. Rising Stars names the state's top up-and-coming attorneys.