To make their insurance more affordable, families making less than $88,000 a year will have their monthly premiums capped at anywhere from 2 to 9.5 percent of their income. Right now there is no cap. And a significant change - young adults can now stay on their parents' coverage until age 26.
In exchange for the help, those who refuse to buy health insurance will pay an annual penalty of $95 in 2014.
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Finally, insurance companies can no longer deny coverage to those with pre-existing conditions. For adults that rule begins in 2014. For children, it goes into effect six months after the bill is signed.
That's good news for 6-year-old Lucas Avant.
He currently has no insurance because he had Kawasaki Syndrome - a treatable heart problem when he was 9 months old.
Lucas' mother Beth said, "we've applied to about six different insurance providers, and we've been denied by all of them."
Under the bill, Lucas and the 12.6 million other Americans struggling to get health insurance because of pre-existing conditions will now be able to get coverage.
But 29-year-old Michael Mount isn't so thrilled. He's young and healthy and doesn't have health insurance because it costs too much.
"Unfortunately, I look at health insurance and health benefits as more of a luxury item than a necessity," Mount said.
Under the bill Mount is now required to buy insurance by 2014 which could cost him nearly $200 per month. If he refuses, that $95 penalty will increase to nearly $700 by 2016.
He thinks health care still needs to be more affordable, but for the 32 million uninsured Americans about to get coverage - it's a start.