Kids are early beneficiaries in health care reform

 The first stage of President Barack Obama's health-care overhaul is expected to provide coverage to about 1 million uninsured Americans by next year, including children in poor health and young adults, according to government estimates.

That's a small share of the uninsured, but in a shaky economy, experts say it's notable.

Many others -- more than 100 million people -- are getting new benefits that improve their existing coverage.

Overall costs appear modest at this point, split among taxpayers, employers and individuals who directly benefit, although the biggest part of the health care expansion is still four years away.

For weeks, the White House has been touting the new law's initial benefit changes, even as Obama dares Republicans to make good on their threat to repeal his signature social policy achievement. Now, a clearer picture is starting to emerge from the patchwork of news releases.

In 2014, government tax credits will help uninsured workers and their families pay premiums, and Medicaid will take in many more low-income people. Eventually, more than 30 million will gain coverage, sharply reducing the number of uninsured and putting the nation on a path to coverage for all citizens and legal immigrants.

"We've seen increasing numbers of people losing their health insurance, particularly in this recession," said Sara Collins, vice president of the Commonwealth Fund, a New York-based health research clearinghouse. "Providing this early relief will help people who are particularly affected by the downturn." Collins reviewed coverage estimates in federal regulations for The Associated Press.

Among the beneficiaries will be many people locked out of insurance because of medical problems, including the elimination of lifetime coverage limits and a ban on insurers turning away children in poor health.

The major early coverage benefits include:

1. Allowing young adults to stay on their parents' coverage until they turn 26. In 2011, an estimated 650,000 young people who would otherwise have been uninsured will gain coverage. Another 600,000 will benefit by switching from individually purchased policies to less costly, more comprehensive employer plans. The number with coverage will grow in 2012 and 2013.

2. A health plan for uninsured people with pre-existing health conditions. From 200,000 to 400,000 could benefit in 2011, according to the Congressional Budget Office. The government may limit enrollment if $5 billion allocated through 2013 starts to run out, as projected. Beginning in 2014, insurers will be required to accept all applicants, regardless of medical history.

3. Ending lifetime limits on coverage, and restricting annual limits. As many as 20,400 people a year hit lifetime limits, as did Mira Raether. Many more - an estimated 102 million - are in plans that impose such limits and will no longer be able to do so.

4. Requiring insurers to cover children with medical problems. An estimated 51,000 uninsured children are expected to gain coverage.

Another 90,000 children who have been excluded for coverage for a particular condition - asthma, for example - will also benefit.

Many Americans covered through employers won't see the changes until Jan. 1, the start of their next health plan year. That means 2011 will be the first year that the early benefits are fully in place.

What that entails for costs is a matter of intense speculation.

A recent survey of employers by benefits consultant Mercer found that 42 percent expect an increase of 2 percent or less, while one-fourth expect an increase of 3 percent or more.

Government estimates are generally lower.