The Senate bill includes a grandfather policy that allows people who like their current coverage, to keep it. The Presidents Proposal adds certain important consumer protections to these grandfathered plans. Within months of legislation being enacted, it requires plans to cover adult dependents up to age 26, prohibits rescissions, mandates that plans have a stronger appeals process, and requires State insurance authorities to conduct annual rate review, backed up by the oversight of the HHS Secretary. When the exchanges begin in 2014, the Presidents Proposal adds new protections that prohibit all annual and lifetime limits, ban pre-existing condition exclusions, and prohibit discrimination in favor of highly compensated individuals. Beginning in 2018, the Presidents Proposal requires grandfathered plans to cover proven preventive services with no cost sharing.