March 23, 2010: President Barack Obama signs the Patient Protection and Affordable Care Act.

  • Coverage required for children with pre-existing conditions and young adults under 26.
  • Insurers prohibited from placing lifetime limits on coverage and arbitrarily canceling coverage.
  • Insurers must cover certain preventive health services for free, with no copays or deductibles, such as colonoscopy screening, Pap smears and mammograms, and flu shots.
  • Small business tax credit kicks in.
  • Temporary coverage for adults with pre-existing conditions.


  • Prescription drug discounts for seniors.
  • Free Medicare preventive services for seniors.
  • The “80/20 Rule” requires insurers to use at least 80 cents out of every premium dollar to pay for medical claims, instead of overhead costs.
  • Insurance companies must publicly justify any rate increase of 10 percent or more before raising premiums.


  • Most health plans must cover additional preventive health services for women, such as breast cancer screenings.
  • Consumers must be provided easy-to-understand summaries about a health plan’s benefits and coverage.


  • Oct. 1: health insurance marketplaces open for enrollment.


  • Jan. 1: Coverage purchased in the health insurance marketplace takes effect.
  • March 31: Open enrollment on the health insurance marketplace ends.
  • All Americans, with few exceptions, must have health insurance or face a penalty.
  • Insurers can’t deny people with pre-existing health conditions.
  • Consumers shopping on the marketplace can save on monthly premiums and out-of-pocket costs with federal subsidies and tax credits.
  • Nearly all plans, sold through the marketplaces and otherwise, must cover a basic set of health benefits, including emergency care, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs and pediatric dental and vision care.
  • The Medicaid expansion takes effect (not in states including Maine that opted out).
  • Insurers can’t set yearly limits on what they spend on your coverage.
  • Small business tax credit expands.


  • Employers with at least 50 full-time workers must offer health insurance to their employees or face a penalty.

I'm the health editor for the Bangor Daily News, a Bangor native, a UMaine grad, and a weekend crossword warrior. I never get sick of writing about Maine people, geeking out over health care data, and...