Parts of Affordable Care Act already in effect Updated: Tuesday, September 10, 2013 | (NEWSCHANNEL 3) - Enrollment in the Federal Health Care Exchange begins in just over three weeks, but many changes as a result of the Affordable Care Act have already happened over the past few years.Newschannel 3 took a look at some of the rules that have already taken effect.Caleb Buhs, a public information officer with the Department of Insurance, says there are too many unknowns when it comes to the Affordable Care Act."There's still a lot of people, I think, who are unaware of what all the changes are and what they mean for them," Buhs said.One common misconception is that the Affordable Care Act won't take effect until next year, when in fact, many changes have already happened.Insurance companies can no longer drop you or place a lifetime cap on your coverage. They also can't refuse you for pre-existing conditions, and young adults up to 26 may be covered by their parents policies.However, the law has also reduced by half the amount you can save every year in a flexible spending account to cover medical bills--down to $2,500 in 2013, and has increased the income threshold for claiming itemized tax deductions for medical expenses to 10 percent from 7.5.There are also new taxes affecting West Michigan industry, which took effect this year.There's a new 2.3 percent excise tax on medical device manufacturers. According to some reports, Kalamazoo-based Stryker has laid off more than 1,000 people because of it, and owes the federal government upwards of $100 million this year alone.Late last week, a Stryker spokesperson told Newschannel 3 that the Affordable Care Act will cost the company 20 percent of its total research and development investments.Although its no secret that drugmakers like Pfizer stand to profit billions because of the increased numbers of insured Americans and the corresponding increased need for medications, but they're being hit with an excise tax as well on brand name drugs running into the tens of billions of dollars.But the most significant and noticeable change already in effect is that all preventative medical care is covered 100 percent, with no deductibles to meet, and no co-pays.That means screenings for pre-diabetes, one of Michigan's most critical health problems, are completely free."We're seeing an explosion in Michigan," said Dr. Michael Valitutto. "About 10 percent of our population has type 2 diabetes, and it's expected to increase--triple by the year 2015."Dr. Valitutto says preventative care saves lives, but Americans have a nasty habit of ignoring those warnings, and not just for diabetes."A lot of the time, patients don't get their mammograms, they don't go for their routine exams, looking at their cholesterol, their colonoscopies over the age of 50," Dr. Valitutto said. "All these things should be routine and I think the majority of Americans are not taking advantage of that."So he hopes the change won't go unnoticed, and that more people will actually go to the doctor."If they don't have the money out of pocket, maybe they'll be more apt to go to the physician; that would be a very good thing," Dr. Valitutto said.