But it makes several major changes to the main healthcare bill, including expanding subsidies that the federal government will provide to low- and moderate-income Americans starting in 2014 to help them buy health insurance.
The package also scales back a new 40% excise tax on high-end "Cadillac" health plans and delays its implementation until 2018.
It imposes a new tax on couples making more than $250,000, who will pay a 3.8% Medicare tax on capital gains and other investment income for the first time.
The bill boosts federal aid to states to help them expand their Medicaid programs, replacing a provision in the main healthcare bill that singled out Nebraska for special assistance.
And it would gradually close the gap in Medicare drug coverage known as the "doughnut hole," phasing it out completely by 2020.
Together, the healthcare legislation signed by the president and the reconciliation package approved Thursday are expected to cover an additional 32 million Americans by 2019, boosting the percentage of non-elderly Americans with insurance from 83% to 94%, according to estimates by the nonpartisan Congressional Budget Office.
The bill also establishes a broad new framework of government regulation to prevent insurance companies from denying coverage to people who are sick and to require insurers to provide a minimal level of benefits.
The coverage expansion would not be cheap, requiring an estimated $938 billion over the next decade to expand Medicaid, to give tax credits to small businesses to help them cover their employees and to provide insurance subsidies to Americans who do not get benefits at work.
Most Americans will for the first time be required to carry health insurance or pay a penalty.
Because the cost of the expanding coverage is offset by new taxes and cuts in what Medicare will pay insurers, hospitals and other providers over the next decade, the Congressional Budget Office estimated that the legislation will actually reduce the deficit slightly by 2019 by an estimated $143 billion.
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