The headline from the New York Daily News on Monday, 22 March 2010. Credit: NYDailyNews

President Obama has finally succeeded in getting his healthcare reforms through Congress.

It is the most significant piece of US social legislation for decades, giving health insurance to an additional 32 million Americans.

But what impact will the new measures have? Below, four regular Americans give their diagnosis of the landmark US healthcare bill.

Kate will be able to stay on her parents' health insurance

Kate is a university student, due to graduate later this year. She was diagnosed with rheumatoid arthritis at the age of nine.

I am thrilled, relieved, and nervous that the bill has passed!

It mandates that insurers cover adult children up to age 26, so I will be able to stay on my parents' health insurance until I enter graduate school. If my parents' health insurance gets too expensive, I will be able to get Medicaid insurance since my job as an assistant researcher pays less than $15,000 per year. And most importantly, insurers will no longer be allowed to discriminate against me for the disease I developed as a child. Insurance companies have refused or rescinded coverage to tens of thousands of people on the basis of pre-existing conditions, as described in Congressional reports, but now that heartless practice is illegal.

I have followed the process closely. I am president of the reproductive rights group on my campus and was outraged by Representative Bart Stupak's crusade to derail this legislation. This bill is not about abortion, it is about making sure 32 million Americans can go to a doctor. When I developed appendicitis, I went promptly to the doctor and the organ was removed before it ruptured. The bill for the surgery and two nights' hospital stay was $8,000.

Insurers will no longer be allowed to discriminate against me for the disease I developed as a child

Had I not had insurance, I might have waited until I passed out from the pain of a ruptured appendix, and spent weeks in the hospital, generating bills I could not pay (though my credit would be ruined)- the cost of which would be shifted onto the taxpayer through fewer hospital resources, higher charges by doctors, higher insurance premiums.

I am worried about how this bill will affect public perception of Obama's presidency in crucial rural voting districts. I am a Democrat, and a strong Obama supporter. I am worried Americans do not fully realize the degree to which wealthy, the middle class, and the poor are all deeply intertwined. Health care is not a commodity that responds to free market economics; hospitals are mandated by law to treat every patient, regardless of whether the patient can pay. If patients can't pay, the cost is transferred to those who can pay.

America does not leave people to die outside emergency rooms. Americans donated millions to Haiti after the devastating earthquake, and airlifted the most critical to our own hospitals, absorbing that cost. We are a nation of people who do not ignore the suffering of others. I am so proud that 219 representatives of over 300 million Americans brought 32 million of their fellow citizens in from the cold. This is wonderful, momentous occasion!

Megan joined hundreds of protesters on Capitol Hill on Sunday

Megan is a high school teacher who has insurance through her employer.

I have friends who work on the Hill, so I have followed the process rather closely. Everyone was shocked at how quickly this bill came up for a vote. It seemed underhanded.

This bill does not ensure that it will prevent tax payer money from funding abortions. So, in essence, my hard-earned money will most likely be funding someone else's abortion. I am adamantly opposed to this as I am Catholic and, therefore, believe in the sanctity of all human life from conception to natural death. In that same vein, this bill does not protect health care workers' conscience rights. Without a conscience clause, doctors and nurses will be forced to perform abortions and other end-of-life mandates. They will be forced to choose between their moral beliefs and their career. Catholic hospitals - which make up a quarter of all hospitals in the United States - will be forced to close.

The United States of America was built on freedom. The Declaration of Independence guarantees its citizens the right to life, liberty, and the pursuit of happiness. Men and women still die to uphold these rights. How can we possibly pursue happiness if our rights to life and liberty are no longer protected in law?

I am in utter disbelief. I thought that this bill would be defeated. I thought that our representatives actually listened to the people. Every time I tried to call my representatives, their lines were disconnected or their mailboxes were full. Sadly, I believe that President Obama has officially created the beginning of Socialism in the United States of America.

Ronald will be eligible for Medicare by the time the new provisions come into effect

Ronald, who is in his sixties, has been uninsured for three years.

I'm currently attempting to start my own business after being fired due to the Great Recession that affected the retail industry I worked in for 16 years. The healthcare program, that the prior business I worked for offered, provided medical care only (no dental) at a cost of $360 per month until I turned 60 then the premium went up to $680 a month, plus co-pays and deductibles, making it unaffordable as it would have consumed almost half my monthly finances to sustain it.

I currently don't qualify for Medicaid and unless my financial situation improves, or affordable medical insurance becomes available, will have to gamble that I stay healthy for a few more years.

I'm surprised and guardedly optimistic about the healthcare bill, and not surprised that Republicans voted against the bill as their party dogma preaches less government involvement in business and states rights. I think this program is perceived as a social welfare answer to the failings of the current health care system and, although the US administers one of the most successful social programs in the world, in the Social Security Program, it is still perceived by many as just more government involvement in their lives.

My understanding is that most of the healthcare bill provisions will not come into effect until 2014 and I will be eligible for Medicare before then so unless the plan offers choices that compete with Medicare, in cost and services, I don't see how it will affect me. The "donut hole" provision will be a benefit if I'm taking prescription drugs at the time. Although it is unrealistic to think a program of this magnitude could be in place in a few months, four years for full implementation is a long time.

I was following the process closely at first, even reading the entire contents of the first bill, until the partisan posturing, party jumping, self interest, concession to big business, lies and outright childish behavior began, then it frankly became a politics as usual embarrassment. After that I followed the key points but didn't hold out any hope that the 35 million uninsured Americans would see anything of value.

I think it can be a momentous occasion if the opposition also embraces the program and sees to it that it works. If those opposed dig in their heels, succumb to self interest, and work to see that the program fails then it will turn into a burden instead of a safe haven.

Kathie followed the year long process very closely

Kathie owns a veterinary practice and voluntarily provides the total cost of health insurance for her employees.

I am outraged. Our government has slipped from a representative republic into a tyranny. Our supposed representatives care nothing for our opinions or our wishes.

This bill represents the first steps toward Socialized Health Care. We lose our freedom to choose.

Initially my taxes will increase to support the system. Eventually, the insurance companies will fail because of impossible burdens placed upon them by the government. When that happens, the government will be the only source for the required insurance. We will be fined if we do not buy insurance. The private practice of medicine will gradually become a thing of the past. When that happens, I will be at the mercy of the government for health care. It only takes a look around the globe to see how well that works.

The private practice of medicine will gradually become a thing of the past

I followed the whole process very closely. I attended the town hall meeting but unfortunately our "representative" did not attend. Representative Heath Shuler has dodged the voters at every turn. Our Town Hall meeting consisted of a large crowd of constituents speaking to an empty chair with his name on it.

If Americans have any brains or guts left, there will be nothing other than scorched earth where Democrats/Progressives once stood after the 2010 and 2012 elections.

It was important to be at Capitol Hill [on Sunday] to be certain that our representatives would know how we felt. It was equally important to be there in support of the other Patriots. We must give each other support and encouragement for whatever is to come. Our republic will not fall without a fight. The Democrats/Progressives declared war on the American people last night.

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