So what happens now? This:

Now

• $250 rebate checks are sent to senior citizens who hit the “doughnut hole” in their prescription drug coverage in 2010. (Government to pay an increasing share of “doughnut hole” expenditures through 2020 when the gap will be filled.)
• Small businesses are eligible for tax credits, up to 35 percent of premiums, for purchase of employees' health insurance.

In 90 Days (June 21^st)

• High-risk pools to insure Americans deemed “uninsurable” because of preexisting conditions are established. 

• Insurers are prohibited from denying coverage to children based on preexisting conditions.
• Insurers are prohibited from rescinding coverage.
• Insurers are prohibited from setting life-time limits on benefits.
• Children are eligible to remain on parents’ insurance plans until age 26.

In 9 Months (January 1^st, 2011)

• Insurers are required to spend 80 to 85 percent of premiums on medical care. (Currently they spend as little as 60 percent.)
• Medicare patients are eligible for annual free preventive care services, such as cancer screening. (Currently these require copayments.)  

In 2011

• Drug manufacturers start paying $16 billion, and health insurers $47 billion, in fees through 2019.
• Cuts to Medicare Advantage, totalling $132 billion over ten years, start.
• Restaurant chains with 20 or more outlets are required to post calorie information on menus and drive-through signs.

In 2013

• Individuals earning over $200,000 and couples earning over $250,000 start paying higher Medicare taxes (rising 0.9 percent to 2.35 percent) and a new tax of 3.8 percent on unearned income (dividends, interest).
• Medical device manufacturers start paying a 2.9 percent excise tax on sales.

In 2014

• Health insurance exchanges—marketplaces where people without work-based coverage can buy insurance—become operational.
• Most people are required to buy health insurance.
• People with incomes up to 133 percent of poverty are eligible for Medicaid.
• Subsidies to help lower- and middle-income Americans buy health coverage are introduced.
• Insurers are prohibited from denying coverage to anyone based on preexisting conditions.
• Insurers are prohibited from imposing annual limits on benefits. 

In 2018

• A 40 percent excise tax on “Cadillac” insurance plans (plans costing over $10,200 for individuals or $27,500 for families) is introduced.

• 32 million currently uninsured Americans are insured. 

There are, of course, costs associated with the benefits of health care reform (and I’ve noted a bunch of them). But the case that health care reform doesn’t, on balance, make us a better society—let alone create a “health care gulag” (John Cornyn) or “ruin our country” (John Boehner)—is hard to make.