Associate Level Material

Appendix A: U.S Health Care Timeline

Use the following timeline or create a timeline of your own with eight major events, including the
four provided below, from the last 50 years. You may change the dates in the box to match the
dates of your events. Include the following in your timeline:

Medicare and Medicaid

HIPAA of 1996
State Childrens Health Insurance Program (SCHIP)
Prospective Payment System (PPS)

1954
1965
1983

1988

1996

2009

Revenue Act of 1954 is passed to exclude

employers contributions to employees health plans
from taxable income.
The Medicare and Medicaid programs are signed
into law to help provide funding for home health
care, long-term care and insurance for the poor and
disabled.
The PPS was established by the Center for Medicare
and Medicaid Services (CMS) in 1983, specifically to
address expensive hospital care. Regardless of
services provided, payment was of an established
fee. The idea was to encourage hospitals to tame
increasingly expensive hospital care.
Medicare Catastrophic Coverage Act (MCCA)
expands Medicare coverage to include prescription
drugs and a cap on beneficiaries' out-of-pocket
expenses. However, many believed the costs that
were to be borne by the elderly outweighed the
benefits. The Family Support Act requires states to
extend 12 months of transitional Medicaid coverage
to families leaving welfare due to earnings from
work.
Health Insurance Portability and Accountability Act
(HIPAA) restricts use of pre-existing conditions in
health insurance coverage determinations, sets
standards for medical records privacy, and
establishes tax-favored treatment of long-term care
insurance.
The Children's Health Insurance Program (CHIP) is
reauthorized, providing states with additional
funding, new tools land fiscal incentives to help
reach an estimated 4.1 million children through
Medicaid and CHIP who otherwise would have been

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uninsured by 2013.

2010

The House of Representatives passes the Senate

bill, the Patient Protection and Affordable Care Act
and sends it to the President for signature. The
historic health reform legislation requires that all
individuals have health insurance beginning in 2014.
The poorest will be covered under a Medicaid
expansion. Those with low and middle incomes who
do not have access to affordable coverage through
their jobs will be able to purchase coverage with
federal subsidies through new "American Health
Benefit Exchanges." Employers are not mandated to
provide health benefits, however large businesses
whose employees receive insurance subsidies will
pay penalties. Small businesses will be able to
access more plans through a separate Exchange.
Health plans will not be allowed to deny 2010
National Health Reform Enacted coverage to people
for any reason, including their health status, nor can
they charge more because of a person's health or
gender. Young adults will now have the option of
being covered under their parents' plan up to age 26.

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