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Extra12/21/2009 5:13 PM ET

Health reform: What's in it for you?

Senate Democrats say they expect to approve a health care overhaul before Christmas. Here's a look at how the legislative package might affect Americans.

By The Associated Press

As Congress gets closer to a final health care bill, many Americans want to know: What's in it for me?

The answer is: It depends.

On your age and household income. Whether you own a business and whether it's big or small. Whether you're insured now and who provides that insurance. In the end, it will depend on how House and Senate negotiators will merge the proposals, and how their vision gets translated into regulations.

Five Americans shared their stories with The Associated Press. Here's an educated guess on how the health care package taking shape in Congress might affect them.

Holly Brown

Home: Round Lake, Ill.

Age: 28

Employment: Student, working part time, receiving unemployment benefits.

Household income: About $15,000.

Coverage: Insured but struggling to afford it.

Brown was laid off last year from a job she'd held for four years. She's stayed insured because of the government COBRA program, which allows workers to remain on a health plan for 18 months after they leave their jobs, if they pay the premiums.

Brown works part time and studies medical imaging at College of Lake County. She has a chronic lung condition and was in the emergency room in November with flu and pneumonia. She's paid about $1,000 in medical bills this year that her insurance didn't cover.

She doesn't know how she'll pay her $500 premium this month because a government subsidy that helped her afford the premium has expired.

"It's scary to think about what's going to happen if I can't make the payment by the end of the month," Brown said.

The health care overhaul taking shape in Congress would require her to buy health insurance or pay a penalty. She could pick a plan offered through new state-based insurance exchanges and she would qualify for a subsidy to help pay her premiums because she makes less than 400% of the poverty level ($43,320 for an individual in 2009). But all those benefits wouldn't kick in until 2013 in the House bill (2014 in the Senate legislation). Because of her medical problem, she may be able to qualify for coverage during the transition period by going through high-risk insurance pools called for in the legislation.

Glenn Nishimura

Home: Little Rock, Ark.

Age: 60

Employment: Consultant to nonprofit groups.

Household income: $55,000, including wife's earnings.

Coverage: Uninsured since COBRA expired in May.

Nishimura left a full-time job with benefits in October 2007 thinking he'd be able to find another good position.

Then the recession hit.

He's now a self-employed consultant. Since May, he's been without health insurance. For 18 months, he bought insurance through the COBRA program. When that ran out, he tried to find other coverage. He's been turned down by five insurance companies because he has high blood pressure and high blood sugar levels, even though he's otherwise healthy, has never been hospitalized and controls his conditions through diet and exercise.

"I could get H1N1 or get into an accident and I would be potentially bankrupt," Nishimura said. "It's an untenable situation."

The Medicare buy-in proposal considered in the Senate could have helped Nishimura get insurance, as would portions of both the House and Senate bills that would ban denials for pre-existing conditions. But opposition from moderates and a few liberals is forcing Senate Democratic leaders to scrap the idea of a buy-in to get a bill completed.

Nishimura said he e-mailed President Barack Obama suggesting that lowering the Medicare eligibility age to 55 or 60 would create jobs. "I know a lot of people who would like to retire early, but can't because of health care," he said.

David W. Brown

Home: Philadelphia

Age: 47

Employment: Owner of BrownPartners, an advertising and marketing agency. Seven employees. $336,000 in annual wages paid.

Household income: $150,000, including wife's earnings.

Coverage: Provides health, dental and vision coverage to employees.

An ad agency owner, Brown has been able to offer health insurance to his seven employees, but has had to cut benefits because of rising costs. Like other business owners, Brown is trying to figure out what will emerge from Congress and how it will affect him.

"We haven't been able to be as generous as we have in the past," Brown said of the insurance plan he offers his workers. "The good thing is, not a lot of folks are leaving because somebody else has a better plan."

Health care overhaul might help Brown and his wife with coverage for their daughters, now age 17 and 20. The proposals would allow young adults to stay on their parents' insurance plans as dependents into their mid-20s.

Brown would be able to shop for insurance for his workers through a health insurance exchange. Neither of the bills would require him to provide coverage. Both bills provide tax credits to help small companies with average wages of less than $40,000 provide health insurance. But pay levels in Brown's agency are above that cutoff.

Continued: Among the most at risk

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