Today President Obama signed the "Patient Protection and Affordable Care Act" into law. This health care reform bill, HR 4872, was passed in both the House and Senate on partisan lines with none of the Republicans voting for it, but the fat lady has not sung yet. This 2,074 page bill, that is being challenged by at least 14 states on constitutional grounds, has a small second part working its way through the legislative system. Therefore, we will need to let the dust settle before we know what this reform is going to look like, but here is a summary of the bill that President Obama just signed into law:

• Coverage - The health care reform bill will expand coverage to 32 million American who currently have no health insurance.

• Individual Mandate - Everyone will be required to be covered by a health insurance policy, however, people with certain religious beliefs, people who have Indian heritage, and people with very low incomes (around $10,000 for individuals and $20,000 for couples) are excluded from this requirement. Government subsidies on a sliding scale will be available for people who make up to $43,000 for individuals, or $88,000 for a family of four. There are penalties for people who refuse to buy coverage of $95 in 2014, or up to 1% of income for individuals, whichever is greater, and this goes up to $695 in 2016 or 2.5% of income.

• Pre-Existing Conditions - People cannot be turned down based on pre-existing conditions starting in 2014.

• Lifetime Payment Caps - Insurance companies can no longer limit the amount paid out to treat people covered under their policies and policies cannot be cancelled.

• Dependent Child Coverage - Insurance companies must now continue coverage for unmarried children, up to the age of 26, who are on their parent's policies. 

• State Insurance Exchange - This new system allows individuals and businesses to shop for health insurance on state run exchanges. Consumers will now be able to shop for policies based on rates and coverage without all the fine print in contracts that makes it so difficult to compare policies. By 2014 states will be required to set up SHOP exchanges for small businesses of 100 or fewer employees. These SHOP exchanges will allow businesses to pool together to buy insurance at a bigger discount. However, until these exchanges start operating in 2014 the government will provide a tax credit of up to 50% of the premium amount.

• How Is This Bill Paid For? - If you make over $200,000 per year in income your Medicare payroll taxes will increase to 2.8% (.9% increase) in 2013, and there is a new Medicare tax of 3.8% on investment income for these high income individuals. Insurance companies will be required to pay a 40% tax on Cadillac plans of $10,200 or more per person starting in 2018. Medicare Advantage is reducing coverage to 8.5 million seniors by reducing payments and setting a maximum overhead of 15% for insurance companies. Individuals between the ages of 60 to 64 cannot be required to pay more than 3 times the premiums paid by people in their 20's. The penalty for withdrawing funds from a Health Savings Account for non-medical expenses will increase by 5 to 10%. Insurance companies will be required to pay an annual fee to help pay for the exchanges.

• Preventive Services - Insurance companies will now be required to cover certain preventive services, test, and screenings without deductibles.

• High Risk Pools - People who have serious health conditions will be able to buy insurance for the same premiums as healthy people through government-subsidized state run exchanges.

• Unemployed People - New less expensive insurance options will be available for people who lose or quit their jobs.

• Medicaid and Medicare Doughnut Hole - Senior citizens who fall into the Medicare prescription drug doughnut hole will get help with a 50% discount on some drugs from the drug companies and another 25% discount paid for by the government. Drug makers will be charged a new fee, and the hole is completely closed by 2020. Medicaid coverage will be expanded to cover people up to 133% of the poverty level and childless adults, and the federal government will reimburse states 100% of their cost for new people coming into the system until 2016. Illegal immigrants will not be eligible for Medicaid. A new board will be created to help curb Medicare cost.

• Gender Discrimination - Insurance companies will no longer be allowed to charge different premiums based on gender.

• Abortions - No federal or taxpayer dollars can be used to pay for abortions or abortion coverage in insurance policies.

• Tanning Bed Tax - There is a new 10% tax on consumers who use tanning beds.

• Medicare Drugs - The government still cannot negotiate for lower prices from drug companies and it still cannot re-import drugs.

• Tort Reforms - none in this bill.

• Shopping for health insurance across state lines - not allowed in this bill.

• Expanded Tax-Free Medical Savings Accounts - not included in this bill.

• Public Option - There is no public option in this bill.