Grandfathered Health Plans Under the Patient Protection and Affordable Care Act (PPACA)

Bernadette Fernandez
Analyst in Health Care Financing

The Patient Protection and Affordable Care Act (P.L. 111-148, PPACA),1 as amended, includes provisions for the grandfathering of existing health insurance plans. Given that most Americans had private health insurance coverage on the date of enactment of PPACA, most Americans' health coverage will be affected by the grandfathering provisions. This report describes grandfathered plans and summarizes the PPACA insurance reforms that will affect such plans, including the requirements concerning medical loss ratios, dependent coverage, and preexisting health condition coverage. It also discusses issues addressed during the regulation promulgation process, including the possible loss of grandfathering status.


Date of Report: July 23, 2010
Number of Pages: 8
Order Number: R41166
Price: $19.95

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