Affordable Care Act: New Reforms Take Effect in 2011 that Benefit CVD Patients

Updated:Oct 1,2014

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A number of important provisions of the health reform law (the Affordable Care Act) take effect in 2011, bringing with them new benefits for Americans suffering from or at-risk for heart disease or stroke. Among the new reforms taking effect this year:
  • Medicare beneficiaries will see a number of new benefits this year, including:
    • Beginning January 1, Medicare now covers an annual wellness visit, at no additional cost to the beneficiary;
    • Also beginning January 1, Medicare beneficiaries will be able to receive preventive services, such as screenings for high blood pressure and high cholesterol, tobacco cessation counseling, and flu shots, at no additional cost; and
    • About 4 million Medicare beneficiaries with high prescription drug costs who are adversely impacted by the Medicare prescription drug coverage gap (commonly referred to as the “donut hole”) will receive a 50% discount on brand-name prescription drugs covered by Medicare when they reach the coverage gap this year. Over time, this gap will be entirely eliminated.

  •  Medicare will begin paying a 10% bonus to primary care doctors and other health care professionals in 2011. This will help ensure that enough primary care professionals are available to see Medicare beneficiaries and encourage more new doctors to enter primary care fields.

  • Insurance companies are now required to spend at least 80 to 85% of premium dollars on actual medical care and quality improvement activities, rather than on administrative costs, marketing, or other non-medical expenses.

  • Calorie information will soon be appearing on menus, menu boards, drive-thru menus, and vending machines with 20 or more locations, giving consumers an important new tool for making healthier food choices. Additional nutrition information will also be available upon consumer request.

These reforms build on a number of other provisions of the reform law that took effect in 2010, such as:
  •  Individuals who have had a heart attack, stroke, or other pre-existing medical condition and who have been uninsured for at least six months have a new insurance option available to them called Pre-Existing Condition Insurance Plans.

  • A number of important new insurance protections took effect with health insurance plan years beginning after September 23, 2010; for many Americans with employer-provided coverage who had open enrollment late in 2010, these new benefits began January 1. Among the new reforms: lifetime limits on coverage are now prohibited, young adults can remain on their parents’ policy until age 26; and children can no longer be denied coverage because they have a pre-existing condition.

For more information about the Affordable Care Act or these provisions, please visit the American Heart Association’s health reform website at www.HeartsforHealthCare.org or the U.S. Department of Health and Human Services’ website, www.healthcare.gov.  

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