Health-Care Reform: What Changes Now, and What Will Change Later

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Photo: Chip Somodevilla /Getty Images

The health-care reform bill that was passed last night by Democrats in the House of Representatives is now winding its way to the White House, where it will await President Obama's signature. A package of changes to the bill that was also approved by the House remains to be approved by the Senate, and will likely set off another period of fiery debate — but the main bill includes major changes in America's health-care system that, once signed, will go into effect immediately. So what happens next?

Right away, small business tax credits will go into effect, covering 35 percent of health-care premiums, and seniors will get $250 rebates to help fill the so-called Medicare "doughnut hole." Young people will be able to stay on their parents' health-care plans through the age of 26, and it will be illegal to bar coverage to children with preexisting conditions. It will also be illegal to put caps on the duration of health-insurance plans.

Over the next three years, new fees will be paid by drug companies, insurance companies, and medical device providers adding up to several billion dollars. These will increase over time. Medicare payroll taxes will also increase .9 percent for wealthy individuals and families. Medicaid will be expanded to anyone with an income up to 133 percent of the federal poverty level.

In 2014, almost every American will be required to have health insurance, with exceptions for low-income families and subsidies for low- to middle-income families. The fines will start low ($95) and grow over the next two years to $695 for individuals. Likewise, businesses with more than 50 people will face fines if they do not offer health insurance — and by this time tax credits to businesses with fewer than that many employees will have reached 50 percent. At this time, adults will join children in no longer getting barred from coverage for having preexisting conditions.

By 2018, all health-care plans will have to cover checkups and other preventative services for free. High-end health-care plans will be taxed at 40 percent.

After a decade Democrats say benefits from their plan will close the Medicare "doughnut hole" for prescription drugs for seniors.

Timeline of health care reform: Things may get worse before they get better [NYDN]
What's in the Bill [WSJ]