Health Care Reform has been a major initiative of the Obama Administration since winning the 2008 Election. A variety of bills and potential legislation have been suggested and even passed by both the US House of Representatives and the US Senate. On March 21, 2010, a Sunday, the House passed the Health Care & Education Affordability Reconciliation Act of 2010, a version of which (known as the Patient Protection and Affordable Care Act) had already been passed by the Senate. Passage of this bill by the House is the clearest line to getting health care reform passed for the Democrats of the 111th Congress.

Much of the vote came down to the votes of moderate Democrats who had previously rejected aspects of the House and Senate bills. Much of the attention on March 21st focused on Michigan Democrat Bart Stupak, who had previously inserted the so-called "Stupak Amendment" into a previous House bill, forbidding any federal funds from going to cover abortions or going to health care plans that paid for abortions. Stupak had said he was voting "no" on the bill, but following negotiations with Speaker of the House Nancy Pelosi and Barack Obama, he changed his position to supporting the bill.http://thehill.com/blogs/blog-briefing-room/news/88121-stupak-still-a-no-vote-on-healthcare-bill

• Individuals are mandated by law to have health insurance or face a fine of 2.5% of their adjusted gross incomehttp://www.reuters.com/article/idUSN2115035520100321

• By 2014 companies with more than 50 employees must provide health coverage to full-time employees or face fineshttp://www.reuters.com/article/idUSN2115035520100321

• Federal funds will help people earning up to 400% of the poverty level to get coveragehttp://www.reuters.com/article/idUSN2115035520100321

• Medicaid available to all those earning 133% of the poverty levelhttp://www.reuters.com/article/idUSN2115035520100321

• Bar insurance companies from excluding people based on pre-existing conditionshttp://www.reuters.com/article/idUSN2115035520100321

• Bar insurance companies from dropping policy holders without causehttp://www.reuters.com/article/idUSN2115035520100321

• Minors can remain on their parents' insurance policies until age 26http://www.reuters.com/article/idUSN2115035520100321

• Medicare Advantage insurers must spent 85% of all revenue on medical carehttp://www.reuters.com/article/idUSN2115035520100321

• 40% tax on health care plans exceeding $10,200 for individuals and $27,500 for familieshttp://www.reuters.com/article/idUSN2115035520100321

• New fees on medical device manufacturers, insurance providers and brand-name pharmaceuticalshttp://www.reuters.com/article/idUSN2115035520100321

• Raise payroll taxes on Medicare for individuals earning $200,000 or more and for couples earning $250,000http://www.reuters.com/article/idUSN2115035520100321

• 10% tax on indoor tanning services that use ultraviolet lampshttp://www.reuters.com/article/idUSN2115035520100321

2011http://abclocal.go.com/kabc/story?section=news/consumer&id=7344779

• Voluntary insurance program providing a cash benefit helping disabled people stay in their homes or nursing homes.
• Medicare recipients in the perscription coverage gap will get a 50% discount on brand name drugs, other drugs to begin phasing in so the gap will be closed by 2020.
• A 10% medicare bonus to primary care doctors and surgeons practicing in areas such as inner cities and rural communities which are underserved.
• Payments to Medicare Advantage plans are frozen, part of a plan to reduce payments to private insurers over three to seven years.
• Increased funding to community health centers which provide basic care for uninsured or low-income people.
• Employers must report the value of health care benefits on W-2 statements
• An annual fee on drug makers starting at $2.3 billion and increasing over time.

2012http://abclocal.go.com/kabc/story?section=news/consumer&id=7344779

• Starts a program to create nonprofit insurance co-ops that would compete on the market with commercial insurers.
• Encourages hospitals and doctors to join together in "accountable care organizations" similar to the Mayo Clinic.
• Sets up a program to test ways of paying medical professionals, hospitals, and other care providers who care for medicare patients for the duration of an admission.
• Reduces medicare payments to hospitals with a high rate of preventable readmissions.

2013http://abclocal.go.com/kabc/story?section=news/consumer&id=7344779

• Insurance company paperwork will be standardized
• Medical expense contributions to tax-sheltered flexible spending accounts (FSAs) will be limited to an inflation-adjusted $2,500 a year .
• Threshold for claiming itemized deduction for medical expenses will be raised from 7.5% of income to 10%. Those aged over 65 can still deduct expenses above 7.5% until 2017.
• Couples making over $250,000 and individuals making over $200,000 will pay increased medicare payroll taxes, and the tax rate on wages higher than that will be raised from 1.45% to 2.35%
• 3.8% tax on income from investments
• 2.3% sales tax on medical devices. Exemptions include every day items such as glasses, hearing aids, contact lenses, and other common items which can be bought at a drug store.

2014http://abclocal.go.com/kabc/story?section=news/consumer&id=7344779

• Insurers may no longer deny coverage to or refuse to renew the policy of those with medical problems. Coverage may no longer be limited based on pre-existing conditions.
• Insurance premiums will vary only by age, place of residence, family size, and tobacco use. Differences are limited to 3:1.
• States create health insurance exchanges for individuals and small businesses to shop for coverage from.
• Income based tax credits will be offered for most consumers at the exchanges in order to substantially reduce costs for most. Sliding scale credits will be completely phased out for households above 4 times the federal poverty levelhttp://aspe.hhs.gov/poverty/09poverty.shtml (roughly $88,000 for a family of 4).
• Expansion of medicaid to cover people up to 133% of the federal poverty line (about $29,300 for a family of 4). Childless adults will be covered.
• Except in case of financial hardship citizens and legal residents must have health insurance or pay a fine to the IRS of $95 per person in 2014 up to $695 per person in 2016. The penalty is capped for families at $2,250 and after 2016 will be adjusted for inflation.
• Employers with more than 50 workers will be penalized for $2000 times their total employees if their workers get coverage through the exchange and recieve a tax credit. They may deduct the first 30 workers.

2018http://abclocal.go.com/kabc/story?section=news/consumer&id=7344779

• Employer sponsored health insurance worth more than $10,200 for individuals and $27,500 for families will be taxed at 40 percent of the value of the plan above the thresholds. Like most other provisions this is also adjusted for inflation.

2020http://abclocal.go.com/kabc/story?section=news/consumer&id=7344779

• "Doughnet hole coverage gap" in Medicare's perscription benefit will be phased out and seniors will pay the standard 25% of drug costs until their copayments drop to 5% when rgw catastrophic coverage threshold is reached.