By Tom Curry National affairs writer
msnbc.com
updated 12/30/2009 10:24:38 AM ET 2009-12-30T15:24:38

Claim: Many of the Senate bill's changes in health insurance wouldn't take effect until 2013.

Congress has been debating the most far-reaching overhaul of both private-sector and government-run health insurance since employer-sponsored coverage first became widely available in the 1950s. Some Americans hope for immediate changes in health insurance. But the bill's ambitious scope -- legislating rules on everything from "a reasonable break time for an employee to express breast milk for her nursing child" to a huge expansion of the Medicaid program for low-income people -- means that it will be implemented over several years. "You aren't going to fix a dysfunctional health insurance marketplace in a matter of weeks," said Sen. Ron Wyden, D - Ore., during the Senate debate.

Fact or fiction?
Fact. Some tax increases and fees in the Senate bill would take effect on New Year’s Day 2010, even if the president were to sign the bill into law after Jan. 1. A new $2 billion annual fee on drug manufacturers begins on New Years Day 2010 and a new 10 percent excise tax on indoor tanning services would start on July 1, 2010. But some changes would not take effect until 2013. Among them: the new 40 percent tax on family insurance coverage in excess of $23,000, the prohibition of preexisting condition exclusions, and the subsidies for about 28 million people to buy coverage in new insurance exchanges. Effective immediately upon enactment would be such changes as temporary coverage for uninsured people with preexisting conditions and prohibiting insurers from rescinding coverage except in cases of fraud.

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