Change is scary, especially when the parameters around it are unknown and rather confusing. Health care reform is one of those unnerving changes. The bill will extend insurance coverage to 32 million additional Americans by 2019, but it will certainly affect us all. The question is: how?

Highlights:

The new bill will place more stringent guidelines on health care companies. For example, the plans will have to stop setting lifetime limits on coverage, canceling policies when people get sick and denying people coverage for preexisting conditions (the last will take place in 2014). Another major change is that children and young adults can be covered under their parents until the age of 26.

If you can’t afford health care,

epending on your income, you might be eligible for Medicaid, the state-federal program for the poor and disabled, which will be expanded with the bill. If your income is over the Medicaid limit, but you are still struggling, you may be able to receive government subsidies to help you pay for private insurance from the new state-based insurance marketplaces, called exchanges, slated to begin operation in 2014.

If you already have coverage,

you can keep your plan or buy coverage through these marketplaces.

Beginning this year, Medicare will offer annual checkups and preventive screenings (colon, prostate and breast) free to beneficiaries. Medicaid will also offer additional preventive services without cost to children and adults.

Common Concerns:

Families that make over $250,000 will pay more in Medicare payroll taxes starting in 2018. Their unearned income, now exempt from the payroll tax, would also be subject to a 3.8 percent levy, according to The New York Times.

Most Americans will be required to buy health insurance by 2014 or pay a penalty. The penalty will start at $95 or 1 percent of income in 2014, whichever is higher, rising to $695 or 2.5 percent of income in 2016. However, families would not pay more than $2,085. Some people would be exempt from the requirement because of financial hardship or religious or cultural beliefs.

Flexible spending accounts,

which allow users to put aside untaxed dollars for medical expenses, will be limited to $2,500 and will no longer be usable for over-the-counter medicines

 Who is this for?

If you’re under age 65 and you’re looking for help understanding health care reform, this information can help you sort through the confusion.

One of the goals of the Affordable Care Act is to improve the quality and safety of health care. In that way, health care reform means better care for everyone.

Other provisions of the Affordable Care Act help people get health insurance who couldn’t before. They also help make coverage more affordable. So what does health care reform mean to you? It may depend on how you get your insurance, or whether you have any.

If you’re insured through an employer

Employers with more than 50 full-time employees weren’t required to make changes to the health plans they offer. If your employer has fewer than 50 full-time employees, health care reform means your coverage changed. That’s because small-group health plans must cover the same basic set of benefits and plans you buy yourself.

Regardless of business size, your employer’s plan may not be your only option. If the coverage your employer offers doesn’t meet certain health care reform guidelines, it might be cheaper for you buy your health insurance. Then you may qualify for a tax credit that lowers your costs. What are those guidelines?

• Your annual share of the cost of your plan’s premium for one person is more than 9.5 percent of your household income.
• Your plan doesn’t share at least 60 percent of the cost of covered services.

If you buy your own health insurance

Health care reform brought a lot of changes to people who buy their own health insurance. It means that your health plan:

• Must meet Affordable Care Act requirements.
• Covers a basic set of services, called essential health benefits.
• Falls into one of four metal tiers.

It also means you may be able to get financial assistance from the government that lowers the cost of your health insurance. This assistance is called a subsidy. One subsidy lowers your monthly payment. Another kind of subsidy lowers your share of the costs. Many people qualify. You can use our subsidy estimator to see if you’re eligible.

If you don’t have health insurance

Health care reform has made it possible for more people to get coverage. How?

• Health insurance companies can’t turn you down because you’re sick or have a medical condition. They also can’t charge you more based on your health.
• You may get help paying for your plan, or be eligible for plans with lower deductibles and other cost sharing. This help is called a subsidy.
• More people are now eligible for coverage through the state of Michigan that costs you very little or nothing. These programs include Medicaid, the Healthy Michigan Plan and the Childrens’ Health Insurance Program.

If you’re uninsured, it’s time to get covered. If you don’t, you could pay a fee. Learn 

These are the main committees with jurisdiction over health care. Their legislative recommendations continue paving the way for the Patient Protection and Affordable Care Act — also known as “Obamacare” — to be revised through a legislative process known as reconciliation, according to the announcement issued Monday by the Ways and Means Committee.

President Donald Trump’s Office of Management and Budget director, Mick Mulvaney, tells CBS News Tuesday that the While House worked closely with the House Republicans on the proposal:

Millions of Americans are probably asking that question in the wake of the historic House passage of reform legislation Sunday night. The debate over this issue has been long, heated, and confusing, after all. The bill itself is thousands of pages long. Who has the time to follow that kind of thing when there is laundry to do, and meals to cook, and math homework to check?

The short answer is that healthcare reform will affect families differently, depending on their different circumstances.

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