While many big health reform changes won't happen until 2014, when most people must purchase insurance and many will qualify for subsidies, the law requires insurers to make some changes within a year. How much can these changes help individuals? Will they place too great a burden on insurers?
Within 90 days of enactment, there will be a new high-risk pool to get coverage to those with pre-existing medical conditions.
Adult children will be able to stay on parents' policies up to age 26.
Insurers won't be able to exclude kids from coverage because of pre-existing conditions, rescind coverage except in cases of fraud, or place lifetime limits on coverage.
Insurers will have to provide coverage without cost-sharing for certain preventive services determined by the U.S. Preventive Services Task Force.
Moreover, health plans will have to report how much of their premium dollars go to clinical services, quality and other costs. And they'll have to give consumers rebates if they spend less than 80-85 percent on clinical services. The government will create a process to review health plan premium increases, and plans will have to justify those increases. Currently states monitor premium increases. States will report on premium trend increases and recommend whether certain health plans should be excluded from the health insurance exchange because of unjustified premium increases.