Health Care Reform Bill Summary: A Look At What's in the Bill

Updated March 23, 5 p.m. ET

By CBS News Capitol Hill Producers Jill Jackson and John Nolen

Cost:

• $940 billion over ten years.

Deficit:

• Would reduce the deficit by $143 billion over the first ten years. That is an updated CBO estimate. Their first preliminary estimate said it would reduce the deficit by $130 billion over ten years. Would reduce the deficit by $1.2 trillion dollars in the second ten years.

Read more on the CBO Report
Related: A post-Supreme Court guide to the health care law

Coverage:

• Would expand coverage to 32 million Americans who are currently uninsured.

Health Insurance Exchanges:

• The uninsured and self-employed would be able to purchase insurance through state-based exchanges with subsidies available to individuals and families with income between the 133 percent and 400 percent of poverty level.
• Separate exchanges would be created for small businesses to purchase coverage -- effective 2014.

• Funding available to states to establish exchanges within one year of enactment and until January 1, 2015.

Subsidies:

• Individuals and families who make between 100 percent - 400 percent of the Federal Poverty Level (FPL) and want to purchase their own health insurance on an exchange are eligible for subsidies. They cannot be eligible for Medicare, Medicaid and cannot be covered by an employer. Eligible buyers receive premium credits and there is a cap for how much they have to contribute to their premiums on a sliding scale.

Federal Poverty Level for family of four is $22,050

Paying for the Plan:

• Medicare Payroll tax on investment income -- Starting in 2012, the Medicare Payroll Tax will be expanded to include unearned income. That will be a 3.8 percent tax on investment income for families making more than $250,000 per year ($200,000 for individuals).
• Excise Tax -- Beginning in 2018, insurance companies will pay a 40 percent excise tax on so-called "Cadillac" high-end insurance plans worth over $27,500 for families ($10,200 for individuals). Dental and vision plans are exempt and will not be counted in the total cost of a family's plan.
• Tanning Tax -- 10 percent excise tax on indoor tanning services.

Medicare:

• Closes the Medicare prescription drug "donut hole" by 2020. Seniors who hit the donut hole by 2010 will receive a $250 rebate.
  
• Beginning in 2011, seniors in the gap will receive a 50 percent discount on brand name drugs. The bill also includes $500 billion in Medicare cuts over the next decade.

Medicaid:

• Expands Medicaid to include 133 percent of federal poverty level which is $29,327 for a family of four.
  
• Requires states to expand Medicaid to include childless adults starting in 2014.
  
• Federal Government pays 100 percent of costs for covering newly eligible individuals through 2016.
  
• Illegal immigrants are not eligible for Medicaid.

Insurance Reforms:

• Six months after enactment, insurance companies could no longer denying children coverage based on a preexisting condition.
  
• Starting in 2014, insurance companies cannot deny coverage to anyone with preexisting conditions.
  
• Insurance companies must allow children to stay on their parent's insurance plans until age 26th.

Abortion:

• The bill segregates private insurance premium funds from taxpayer funds. Individuals would have to pay for abortion coverage by making two separate payments, private funds would have to be kept in a separate account from federal and taxpayer funds.
• No health care plan would be required to offer abortion coverage. States could pass legislation choosing to opt out of offering abortion coverage through the exchange.

**Separately, anti-abortion Democrats worked out language with the White House on an executive order that would state that no federal funds can be used to pay for abortions except in the case of rape, incest or health of the mother. (Read more here)

Individual Mandate:

• In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.

Employer Mandate:

• Technically, there is no employer mandate. Employers with more than 50 employees must provide health insurance or pay a fine of $2000 per worker each year if any worker receives federal subsidies to purchase health insurance. Fines applied to entire number of employees minus some allowances.

Immigration:

• Illegal immigrants will not be allowed to buy health insurance in the exchanges -- even if they pay completely with their own money.

More Details of the Bill:

Short-term Benefits From Health Care Reform
GOP Howls at Health Care Sweetheart Deals
College Aid Reform Passes with Health Bill
Health Care Bill Extends Tax to Investments
Read the Text (PDF): Complete Senate Bill | Reconciliation Measure

More Coverage of Health Care Reform:

Health Care Reform: Which Party Comes Out on Top?
Health Care Bill Passed the House, But Battles Ahead in Senate, Court
House Passes Health Care Bill
Poll: Health Care Reform Still Confusing
Analysis: Health Care Debate Shows Ideological Split
Obama: "This is What Change Looks Like"
Health Care Vote: How Each Representative Voted
Announcement of the Vote
Boehner Tells Democrats: Shame on You
Pelosi Urges House to "Make History"
Stupak Called "Baby Killer" for Backing Bill
CBSNews.com Special Report: Health Care

[mgiuseff100]

Does anyone seriously believe this is going to save money in ten years? Every President fees us the same line. Look at the Great Society program that Johnson started back in the 60's to end poverty. The costs were exponentially higher than what he projected, and we never wiped out poverty. This is going to cost us big, at a time when we need to start dealing with our 17 Trillion dollar deficit. Obama is a profligate spender. He will bury us.

[jlp71]

Can anyone please answer me? Does an employer that has only 6 employees have to offer insurance after the first of the year starting in 2013? I have been reading and only find stuff that says 50 or more employees is the new law

[allison-craig]

I for one think that this health care bill is the dumbest thing i have ever heard of. I am a american citizen and should be able to choose on anything if i want it or not. Thats freedom and I think its in vain for all of the American soldiers to die for our freedom if one new President wants to change it all. I'm sorry but i am 20 years old and do not think I need health care at this time and i will use my rights to say no. I will not pay for something i dont need.I work for everything i get and pay my bills with the money i earn.It is hard enough to live for me to just pay my bills other then pay for some thing i will not use for at least another 10 maybe 15 years. I am tired of the people of the United States laying down like dogs. Dose anyone in my or the genoration before me not know our rights. Come on people if yo want to stay free then you need to stand up. If Obama and the Goverment can push this thourght then they no they can take everthing for us. The Goverment was made for the people and by the people. I mean i dont no about anyone elase but i will stand up for my rights!!!

[dynamicsmiles]

The supreme court ruled this law a tax. All revenue bills must orginate in the House not the Senate. The Health Care Mandate orginated in the Senate. How can this be legal? Go here to sign the petition to abolish the mandate.
http://wh.gov/9QuP So with the IRS enforcing it what do you think will happen if you dont have health care and dont pay the tax. What the IRS does. Freeze your bank account, place a lein on your property. Take it and give to the have nots to complete their distribution program.

[hotchocolate010]

I have listen to both sides of this story I currently have private insurance and I still cannot afford to go to the doctor. My grandchild was born with asthma and all they were doing was giving him medicine and sending him home and he was right back to the emergency room all of this is because of managed care. Another thing is health care is one of the governments biggest bill people are not going to doctor like they should because they cant afford it another thing this will stop a lot of fraudelent activities in billing and accounting practices of health care facillities. Many American companies cannot compete within their industry because of health care cost.. So this is just not to give coverage to citizens who do not have heath care. This benefit the whole country is it perfect no nothing in this world is perfect. But we cant continue on this path we are on now. America needs healthy people. Healthy people makes a healthy nation. I also want to add that most non profit hospital receives surtax revenues to serve the indigent that are in their community so now why are these hospial reporting that they have billions or millions of dollars in bad debt of hospital bills being unpaid

[fiddlestickawshucks]

THAT'S A REALLY GOOD QUESTION.!!!!!

Not even Congress and the Senate bothered to read the whole thing before they voted on it.

The fact that it is 2,000 + pages long is no accident.

Obama doesn't want anybody to know everything it includes; such as death squads, that the government will fine you or take over your assets if you refuse to comply; with no recourse on your part.

I venture to say the Supreme Court didn't read it either since they considered it a "tax" and not a "mandate" which is Constitutionally illegal.

If anybody out there still thinks the government is working for the good of the American people, please let me know what you're on.

I really need to smoke it or ingest it to allay my fears about the direction this country i headed for.

[nathanfcampbell]

This is so true. I feel what you are saying. Obama made it so long that once people got so far they would think it was good and just not read the last parts of it. He knows what he was and is doing.

[SonOfMullen]

Why does everyone put it on the president? in what government book that you read does it say that the president writes legislation and writes bills? the only power that the president has over a bill is his signature of approval or his power of veto to deny it as it is written. I am so sick of people saying "Obamacare" it is HEALTHCARE REFORM. The senate and House of Representatives deals with all legislation written and the contents within and has to pass through both sides before it even gets to the president to sign off on it or not. It is basic Government class that surprisingly many are forgetting. The fact that you say not even congress or senate bothered to read before it was voted on is contradictory because they are the ones who write bills not the president. Facts before statements is not too hard to ask for, is it?

[lg144]

Any of you Obama haters have a pre existing condition? Health care providers denies coverage to people with a pre existing condition. How about an adult child younger than 26 unable to get their own health coverage? Any of you at the limits of your health coverage therefore elgible to be dropped by your health care provider?

President Obama's affordable care act fixes those things and others. What are republicans offering in its place? Not a damn thing that helps average Americans.

[darladarlabills]

no one is Obama haters.. we have our own opinions.. the problem is there are those of us who actually have bills to pay and now we have more taxes to pay, penalized for a decision if we cant afford it... Sounds like a bunch of hogwash to me and not fair to other people

[askagain]

lg144 - A person does not have to be an Obama hater to disgree with him or his policies. That is known as a difference of opinion. And yes, those who disagree with Obama need to campaign for candidates closer to their beliefs and values.

[ted2105]

What can I do if the company that I receive my healthcare from says they are exempt from complying with the New Healthcare Law because I am retired and that disqualifies me. Who do I contact? I have two live at home sons that should be covered till age 26, but Coca Cola says they will only be covered if they are a fulltime students. I have a wife that survived breast cancer so far that is not eligible for a mammogram because they say it is preventive care

[Education_is_Key]

Ted,
Sorry to hear what you are going through. The fact that they will not allow you to cover your dependent children that "are not" full time students on medical coverage is a violation of the new law. You can confirm that in the details of the article written above. Also for confirmation you can always speak to your states Health Care Department (they know the law) and as for help, contact your local legislator for direction. I am in HR and believe me YES they do have to cover your children until 26.

[ClivenL]

P.S. and by "it works great for them" (Germany), I mean they have had a similar arrangement in thier country for some time, not that our specifc bill applies to them, ofc.

[Berklawdc]

Constitutionall or not, the health care reform bill is leaving its mark on the health care industry. Some insurance companies are starting to adopt changes put forth by the bill, which is a testament to consumer power. Read more at: http://*******.com/6qwl6kv

[Berklawdc]

www.thecorporateobserver.com