This is the VOA Special English Health Report.

President Obama has signed legislation to make the biggest changes in the health care system in forty-five years. The president said: "Today, after almost a century of trying; today, after over a year of debate; today, after all the votes have been tallied, health insurance reform becomes law in the United States of America.
Many parts of the plan will fully take effect in four years. But some take effect quickly. For example, in six months the new law will bar insurance companies from denying coverage to children with pre-existing health conditions. Adults with pre-existing conditions will be added in four years.
The government will help millions of people pay for insurance. It will also permit millions more to receive free coverage through the Medicaid program for the poor. In all, the plan aims to make health insurance available to thirty-two million people now without it. People will be able to buy private policies through marketplaces called exchanges to be administered by the states. Illegal immigrants will not be able to take part.
An estimated eighty-three percent of people under age sixty-five who are in the United States legally now have insurance coverage. The plan is expected to raise that to ninety-five percent within several years. People over
sixty-five are covered by the Medicare insurance program which the government created in nineteen sixty-five. For the first time, Americans will be required to have health insurance or face a yearly fine starting in four years. The law will also require companies with more than fifty employees to offer coverage. If not, they could face a fine of two thousand dollars a year for every worker. Also, this year the law will start closing what is known as "the doughnut hole." That is a lack of Medicare coverage for some drug costs for older Americans. President Obama promised senior citizens that the reforms will not cut their guaranteed benefits. The Senate quickly made a last set of legislative fixes needed in the new law. However, some states have already gone to court to fight the new health care reform law. The health care plan is expected to cost about nine hundred forty billion dollars over ten years. But it is also expected to help reduce the federal budget deficit. 

And that's the VOA Special English Health report. You can comment on this story at our Web site, voaspecialenglish.com.