A blow-by-blow rundown of when and how the health care bill will take effect. By Kimberly Lankford, Contributing Editor May 31, 2010 June 15, 2010 Medicare beneficiaries who reach the Part D "doughnut hole" start getting a $250 rebate.June 21, 2010 A national high-risk pool offers insurance to people with preexisting conditions until 2014. September 23, 2010 All policies must offer dependent coverage to children up to age 26. Insurers must cover certain preventive services and can no longer impose lifetime limits on the dollar value of coverage, rescind coverage except for fraud, or exclude preexisting conditions for kids. 2011 Medicare recipients get free preventive services and a 50% discount on brand-name drugs purchased in the Part D doughnut hole. Reduction in government payments to private Medicare Advantage plans begins. Advertisement A national, voluntary long-term-care insurance program begins (see Long-Term Care That Falls Short). Reimbursements for over-the-counter drugs in tax-favored medical accounts are no longer allowed. 2013 Flexible spending account contributions are limited to $2,500 a year. The threshold for deducting medical expenses on a tax return rises from 7.5% to 10% of adjusted gross income (those age 65 and older are exempt through 2016). Advertisement The Medicare tax rate on wages jumps 0.9 percentage point on earnings over $200,000 for singles and $250,000 for couples. A Medicare tax of 3.8% on investment income for high-income taxpayers takes effect. 2014 All U.S. citizens and legal residents must have health insurance. Penalties start at the greater of $95 or 1% of income in 2014, rising to $695 or 2.5% of income in 2016. Individuals and small businesses will be able to buy health insurance on state-based health-insurance exchanges. People younger than 65 who earn up to 133% of the poverty level become eligible for Medicaid. A tax credit helps singles earning about $44,000 or less ($88,000 or less for families) buy coverage. 2018 "Cadillac" health plans are hit with a 40% tax on the portion of coverage worth more than $10,200 for individuals or $27,500 for families. How will Obama’s heath care bill affect YOUR small business? Find out by clicking here.