The effective dates of major provisions of the health-care overhaul legislation Within a year (2010) n  Provides a $250 rebate to Medicare prescription drug plan beneficiaries whose initial benefits run out.   90 days after enactment n  Provides immediate access to high-risk pools for people who have no insurance because of preexisting conditions. n    Six months after enactment n  Bars insurers from denying people coverage when they get sick. n  Bars insurers from denying coverage to children who have preexisting conditions. n  Bars insurers from imposing lifetime caps on coverage. n  Requires insurers to allow young people to stay on their parents' policies until age 26.   2011 n  Requires individual and small group market insurance plans to spend 80 percent of premium dollars on medical services. Large group plans would have to spend at least 85 percent.   2013 n  Increases the Medicare payroll tax and expands it to dividend, interest and other unearned income for singles earning more than $200,000 and joint filers making more than $250,000.   2014 n   Provides subsidies for families earning up to 400 percent of the poverty level -- or, under current guidelines, about $88,000 a year -- to purchase health insurance. n  Requires most employers to provide coverage or face penalties. n  Requires most people to obtain coverage or face penalties.   2018 n  Imposes a 40 percent excise tax on high-end insurance policies.   By 2019 n  Expands health insurance coverage to 32 million people.   SOURCES: Speaker of the House, Congressional Budget Office, Kaiser Family Foundation http://www.washingtonpost.com/wp-dyn/content/article/2010/03/23/AR2010032301714.html