Health Care 101: A Consumer Primer on Obama's Bill

President Barack Obama speaks about health care reform, Monday, March 15, 2010, at the Walter F. Ehrnfelt Recreation and Senior Center in Strongsville, Ohio. (AP Photo/Charles Dharapak)

(AP)

It took lawmakers a year to shape President Barack Obama's health care bill. If it finally passes Congress, it'll take the better part of a decade to write the user manual for consumers and doctors, employers and insurance companies.

Some health insurance consumer protections would go into place immediately, significant but limited in scope. The big expansion in coverage comes in four years. About 25 million people would sign up, with most getting tax credits to help pay premiums. Ripple effects continue well after Obama has to leave office in 2017, if he's re-elected.

But even if the 2,700-plus-page bill passes, it's only the end of the beginning. The Obama blueprint will be carried out under less-than-ideal circumstances. Rising medical costs and an aging population will keep squeezing the federal budget. Lawmakers will have to revisit hard choices they sidestepped.

"This is going to play out over a generation," said Andrew Hyman, who oversees health insurance research for the nonpartisan Robert Wood Johnson Foundation. "It will address how people get coverage, how health care is delivered, and how health care is paid for."

The House is expected to vote on the final legislation this week, with the Senate to follow later. Here's a primer on some of the major effects for consumers and other key players:

—IMMEDIATE CHANGES

Uninsured people with medical problems will have a workable alternative. The bill pumps $5 billion into high-risk insurance pools run by the states to provide coverage to those in frail health. Taxpayer-backed insurance won't be free, but premiums should be much lower than what's charged by private insurers willing to take those in poor health.

For people with private health insurance — about two-thirds of Americans — there would be some new safeguards. For example, insurers would be barred from placing lifetime dollar limits on coverage and from canceling policies except in cases of fraud. Children could stay on their parents' coverage until age 26.