Summary of the Senate Health Reform Bill (H.R. 3590)

IMMEDIATE IMPROVEMENTS (2010)

Help getting coverage: New coverage options for people with pre-existing conditions; a website to help identify coverage options in each state; uniform policy documents to make it easier to shop for coverage
Help keeping coverage: Prevent people from being dropped from coverage by insurers (rescissions); extend dependent coverage to age 26
Help paying for coverage: Eliminate lifetime and unreasonable annual benefit limits; caps insurance profits and overhead expenses; temporary reinsurance program for early retirees

Keep the plan you have, whether it's through your employer or purchased individually
Coverage through your employer. If a large employer fails to offer coverage that meets basic standards (high-deductible minimum), and an employee accesses health insurance tax credits through exchange, the employer pays a fine
Coverage in an Exchange, including multiple plans at four different levels of coverage, plus premium assistance tax credits for families (sliding scale up to 400% FPL). The Exchange is open to individuals without other coverage and businesses with up to 100 workers and includes private plans and, unless your state intervenes, a new public health insurance option
Coverage outside an Exchange from regulated plans that can't discriminate based on health status or other health-related factors
Expanded Medicaid eligibility to persons with income under 133% FPL

Beginning in 2014, all legal residents required to have health insurance or pay a penalty of $95 in 2014, $350 in 2015, $750 in 2016 and beyond (indexed for health care inflation). Exemptions if coverage is too expensive or for other reasons.
Secretary of HHS defines a package of "essential health benefits" to be covered in individual, small group, and Exchange plans.
Immigrants: Legal residents eligible for assistance with premiums and cost-sharing through the exchange. Retains five-year wait for Medicaid benefits for adults. Undocumented persons are ineligible to purchase coverage in the Exchange or to receive premiums assistance credits.

No more deductibles or co-pays for preventive care in all plans.
In an individual would not pay higher premiums based on pre-existing conditions, gender, or occupation. Higher premiums based on age are still allowed but limited.
Annual cap on out-of-pocket expenses and prohibits deductibles greater than $2,000 for individuals and $4,000 for families in small business plans.

Investments in the primary care workforce, with bonuses to providers practicing in provider-shortage areas.
Increase the diversity of health professionals and strengthen cultural competence among all providers.
Additional funding for needed data collection and research that helps to identify and eliminate disparities.
Begins a national strategy to improve health care quality, patient outcomes, and population health.
Allows individuals to keep their COBRA coverage until the Exchange is up and running. (2010)

A 40% tax on health benefits that cost more than $23,000 for a family policy or $8,500 for an individual policy, with higher benefits allowable in certain high-cost states and for older workers and those in riskier professions.
Medicare HI tax.
Other provider taxes.

You can download this fact sheet as a Word document or a PDF.