House Health Care Bill: What It Means for You

Nov. 9, 2009— -- Democrats scored a big win this weekend on health care legislation, bringing an overhaul of the U.S. health care system closer to reality. And while the legislation still needs to work its way through the Senate, the House bill offers a glimpse of what could be in store for Americans next year.

Under the House Democrats' bill, which passed Saturday night, all Americans would be required to have health insurance.

Large companies would have to offer coverage to their employees, and both consumers and companies would be slapped with penalties if they defy the government's mandate.

For low-income Americans, the bill would provide subsidies for buying insurance if they don't receive it through an employer. It would also create a federally regulated insurance exchange where individual Americans could shop for coverage.

In the bill's most controversial provision, the government would also sell insurance -– the so-called public option -- although the independent Congressional Budget Office forecasts that premiums for it would be more expensive than for policies sold by private firms.

The bill is projected to expand coverage to 36 million uninsured Americans, resulting in 96 percent of the nation's eligible population having insurance.

For families, the bill would ban insurers from denying coverage because of pre-existing medical conditions and prohibit insurers from dumping people from their coverage if they get sick. Insurers would no longer be able to charge higher premiums on the basis of gender or medical history.

Parents would be able to keep their children on their insurance plans up until age 27 and individuals who have insurance through COBRA would be able to keep their plans until the new health insurance exchange is up and running in 2013.

For seniors on Medicare, the plan would help fill the prescription drug "donut hole" by giving a 50 percent discount on brand-name drugs.

Small businesses would also be eligible to receive federal grants to fund wellness programs for the workplace.

Health Proposal Faces Battle In Senate

To pay for it all, the bill would raise more than $500 billion from a new 5.4 percent income tax surcharge on the wealthy; individuals making more than $500,000 a year and couples making more than $1 million. It would also cut more than $400 billion in Medicare spending.

It's the most ambitious bill to pass the House in more than a generation but its fate is uncertain. Before any of the changes take effect, the bill must be approved by the Senate and signed into law by President Barack Obama.

That is not expected to be an easy or quick process.

The Democrats' health care bill passed by a razor-thin margin in the House with 39 Democrats voting against the bill and one Republican supporting the sweeping plan.

"The House bill is dead on arrival in the Senate," Sen. Lindsay Graham, R-S.C., said Sunday. "Just look at how it passed. It passed 220-215. It passed by two votes."

Sen. Joe Lieberman, the independent Democrat from Connecticut, said Sunday he may join a Republican filibuster of the Democrats' plan. "I'm afraid our colleagues in the House added a lot onto [health care legislation] that subtracts from the genuine purposes of health care reform," he said. "If the public option plan is in there, as a matter of conscience, I will not allow this bill to come to a final vote"

The process is likely to move much more slowly in the Senate, where Majority Leader Harry Reid hasn't even released the version of the bill the Senate will take up. The White House is hoping to have a bill to sign by the end of the year but Senate Democrats privately say that will be virtually impossible.

ABC News' Jonathan Karl and Timothy Johnson contributed to this report.