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What Does Health Care Reform Mean to You? 20 Changes That May Affect You and Your Family Posted: April 22nd, 2010

By Maryalene LaPonsie

Maryalene LaPonsie

After years of discussion and debate, reaching back to the Clinton Administration of the early 90s, substantial health care reform has arrived in the United States. Signed by President Barack Obama on March 23, 2010, the new law makes significant changes to the way Americans get health insurance and how insurance companies do business.

Whether you love or hate the new law, you should know how it may affect you. Clocking in at nearly 2,000 pages, the Patient Protection and Affordable Care Act can be overwhelming to read and review. Below are the top 20 changes included in the new health care reform law. Because the main components of the law are being phased in over a 4 year period, the changes have been broken down into when they go into effect.

90 Days

  • Creation of a Federal High-Risk Pool: The meat of the bill doesn't go into effect until 2014. At that time, American Health Benefit Exchanges are to help families find the cheapest health insurance. In the meantime, the federal government is creating high-risk pools to provide affordable insurance to individuals who are uninsured because of pre-existing conditions.

6 Months

  • Elimination of Rescission: Rescission is when an insurance company decides to drop your health coverage because you become sick. Under the health care reform bill, insurance companies can no longer choose not to renew your policy just because you begin making claims.
  • Coverage for Children with Pre-existing Conditions: Within the next six months, new individual health plans, as well as grandfathered group health plans, are unable to deny coverage to children with pre-existing conditions. Beginning in 2014, this prohibition applies to adults as well.
  • No Lifetime Cap on Coverage: When doing a health insurance comparison, you have undoubtedly seen lifetime caps listed on policies. While these caps may seem generous, it is not hard to reach them if you are diagnosed with cancer or another chronic illness. The health care reform bill eliminates lifetime caps in 2010 and bans annual caps on coverage in 2014.
  • Extended Coverage for Dependents: Instead of getting their own health insurance quotes, your kids can remain on your health insurance plan until they reach age 26.
  • Free Preventative Care: The government believes that healthy people equal cheap health insurance. To help keep you healthy, the reform bill eliminates co-pays on preventative services such as physicals. New plans are impacted in 2010, but Medicare plans are not affected until 2011. Ultimately, all plans are to be barred from charging co-pays for these services by 2018.
  • 10 Percent Tax on Indoor Tanning: First is was cigarettes and alcohol, and now tanning is the latest industry to be hit with a "sin tax." That bronzed glow sees a 10 percent cost increase on July 1, 2010.

Within 1 Year

  • $250 Medicare Refund: While Medicare Part D offers seniors prescription drug coverage, it also comes with a limit. Seniors who hit that limit have to pay for their prescriptions out-of-pocket until they are eligible for catastrophic coverage. Individuals in the Medicare "Donut Hole" may pay up to $3,610 in 2010. However, the federal government is sending them a $250 refund to offset their costs.
  • Reinsurance Program for Early Retirees: If you are between ages 55-64 and retired, a federal reinsurance program may be able to help you find cheap medical insurance until health exchanges are established.
  • Medicaid for Childless Adults: Currently, Medicaid does not provide free health insurance to able-bodied adults without children. The health care reform bill allows, but does not require, states to offer Medicaid to able-bodied adults without children.


  • Limit Administrative Costs: To promote cheap health insurance, the government is limiting how much certain insurance companies can spend on administrative costs, such as salaries. Individual and small group health plans have to spend 80 percent of the money they receive from premiums on medical expenses, while large group insurance companies have to spend 85 percent on these costs.
  • Reduced Medicare Prescription Costs: As the Medicare Part D "Donut Hole" is phased out, seniors paying out-of-pocket for prescriptions can save 50 percent off the cost of brand name prescription drugs.
  • New Requirements for Nutrition Information: A giant burger and fries may be less appetizing when you see how many calories they contain. In 2011, chain restaurants with 20 or more locations are required to disclose nutritional information for menu items.


  • Tax Changes for Medical Expenses: Currently, if you itemize your tax deductions, you can deduct medical expenses that exceed 7.5% of your income from your income tax. In 2013, that percentage increases to 10 percent. In addition, flexible spending accounts, used to pay for medical costs on a tax-free basis, are to be limited to $2,500.


  • Individual Insurance Mandate: This is the big one. In 2014, every man, woman and child, who is a citizen or a legal resident of the United States, is required to maintain health insurance. Businesses that employ more than 50 people must provide insurance as well. Failure to do so results in tax penalties for individuals and businesses.
  • Creation of American Health Benefit Exchanges: As mentioned previously, the government is creating health exchanges to help families find the cheapest health insurance possible. The exchanges are to be state-run and administered by either a governmental agency or a non-profit organization. The hope is that the exchanges may give families their choice of insurer, while using competition to create cheap medical insurance.
  • Subsidies for Families to Buy Insurance: Even though the exchanges are planned to make cheap health insurance available, the government also helps you pay your premiums if you meet certain income criteria. Insurance subsidies are granted to families earning up to 400 percent of the federal poverty limit.
  • Limited Waiting Periods: Also in 2014, insurance companies can only impose waiting periods for coverage of up to 90 days.
  • Expanded Medicaid: If you make less than 133 percent of the federal poverty limit, you are able to get free health insurance through Medicaid. Currently, in most states, only those with children or a disability are eligible. However, in 2014, income is the only requirement for Medicaid eligibility.
  • Limited Deductibles: Finally, deductibles for small group health plans are capped at $2,000 for individuals and $4,000 for families.