The Patient Protection and Affordable Care Act was signed into law by President Obama on March 23, 2010, but the vast changes the law intended to bring about—many of which impact  consumer-driven health plans—are to be phased in gradually over a period of eight years ending in 2018.

Last year ushered in a total of 20 new of the new provisions (17 are effective), and some of these will impact CDHPs. One change has already had an effect on the benefits that can be offered by account-based consumer-driven health plans. Effective Jan. 1, 2011, a health reimbursement account, a health flexible spending account, a health savings account or an Archer medical savings account could no longer be used to cover the costs for over-the-counter drugs not prescribed by a doctor. At the same time, the law also increased the tax on distributions from a HSA or an Archer MSA that are not used for qualified medical expenses from 10 percent to 20 percent of the amount used.

Some good news for the future of CDHPs came in 2011 with the funding of state health insurance exchanges. These exchanges are to go live in 2014 and promise to facilitate the purchase of insurance by individuals and small employers. An HHS Internal Memo from February 2011 spelled out that CDHPs and HSAs would be available on the state exchanges. According to the document, "The new State-based Exchanges will offer individuals, families and small businesses a wide range of plans from lower-cost consumer-driven health plans and those coupled with (HSAs) that tend to have a higher deductibles and higher cost sharing to more comprehensive plans with lower out-of-pocket costs."