Seven Health Reform Provisions That Could Take Effect This Year

Inevitably, as healthcare leaders prepare for changes that may be imposed, "timing will depend on conference and any agreements between the House and Senate on their respective bills," says Matt Fenwick, senior associate director for the American Hospitals Association (AHA). "If/when an agreement is reached, we will work with our members to understand what they need for any transition," he says.

In a Jan. 7 letter to Senate Majority Leader Harry Reid, D-NV, and House Speaker Nancy Pelosi, D-CA, the AHA said it strongly urged conferees to adopt some earlier implementation dates in the House proposal as opposed to the Senate version. Major provisions of the House bill would take effect in 2013, while those in the Senate version would go into effect a year later under the proposals.

For instance, the Senate version of the health plan staggers the implementation of reforms, such as prohibition on coverage of those with pre-existing conditions and lifetime and annual limits—until 2014. "While covering the uninsured is a crucial element of health reform, it also is critical that already insured people are able to keep their coverage," the AHA said in the letter. "Insurance market reform is the area where the greatest consensus lies."

Under the House bill, insurance plans in existence before 2013 would have five years to adopt new requirements to tighten them, while the Senate would exempt such plans from the new rules.

The dates of implementation are among the topics being discussed in the Capitol. "To the extent there are differences between the Senate and House, they are still up for discussion," says Stephanie Lundberg, spokeswoman for House Majority Leader Steny Hoyer, D-MD.

By 2019, there will still be millions of people uninsured in the U.S. regardless of the legislative outcome in Congress, according to the Congressional Budget Office. How many vary by the reform proposal. Under the Senate plan, there will still be 23 million uninsured. The House proposal would cover 5 million additional uninsured people, leaving 18 million uninsured in 2019, according to the CBO.