Expanded coverage

  • A temporary national high-risk pool provides coverage to adults with pre-existing conditions.
  • A temporary reinsurance program assists employers in providing coverage to retirees over age 55 who aren’t eligible for Medicare.
  • Covered dependents must be allowed to stay on health policies until age 26.

Prescription drugs

  • Drug manufacturers must provide a 50 percent discount on brand-name prescriptions filled in the Medicare Part D coverage gap.
  • The rebate percentage for drugs provided under Medicaid is increased.
  • The Food and Drug Administration is authorized to approve generic versions of biologic drugs.

Insurance regulation

  • Health plans are barred from placing lifetime limits on coverage, from rescinding coverage and from excluding coverage for children who have pre-existing conditions.
  • Health plans must report annually how much premium income goes for clinical services, quality improvements and non-claim costs.


  • Chain restaurants and vending machines are required to report the nutritional value of what they sell.
  • A Prevention and Public Health Fund is established to support preventative care and other public health priorities.


  • New physician-owned hospitals are barred from participating in Medicare.
  • Medicare Part B physician premiums and Part D drug premiums increase for some people, based on incomes.
  • Annual increases in hospital payments are limited to account for productivity gains.
  • Providers that qualify as accountable care organizations share in cost savings they achieve for Medicare.


  • An excise tax of 10 percent is imposed on indoor tanning services.
  • An annual fee is imposed on pharmaceutical manufacturers based on annual sales of brand-name drugs.
  • Over-the-counter drugs that aren’t prescribed by a physician may no longer be purchased using tax-advantaged set-asides such as Flexible Spending Accounts and Health Savings Accounts.


  • The new Federal Coordinated Health Care Office within the Centers for Medicare and Medicaid Services is created to improve care coordination for seniors eligible for both programs.
  • Federal payments to states for Medicaid services related to hospital-acquired conditions are prohibited.

Medical malpractice

  • The HHS secretary is authorized to spend $50 million over five years on grants to states to design alternative methods of resolving medical malpractice claims and to encourage more detailed reporting of medical errors.
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