Major Health Care Reforms Kick in Insurers now required to spend 80% of premiums on customers By Rob Quinn, Newser Staff Posted Jan 1, 2011 10:34 AM CST 25 comments Comments Medicare recipients whose drug costs fall between $2,840 and $6,448 a year will get a 50% discount on branded prescription drugs under the new rules. (Getty Images) (Newser) – A rule requiring health insurers to spend at least 80% of premiums on customers and a $2.5 billion tax on drug makers are among the health care reform provisions taking effect today. The new rules also plug the "doughnut hole" in Medicare drug benefits and provide free preventive services like cancer screenings to almost all Medicare beneficiaries, the Washington Post reports. Because the changes largely consist of new rules instead of new spending, they won't be affected by Republican efforts to block health care reform, the Wall Street Journal notes. The most controversial part of the health care overhaul, the requirement for all Americans to buy health care insurance, won't take effect until 2014, if at all. A federal judge declared the requirement unconstitutional last month, although he allowed implementation to continue until a higher court rules on the issue.