Under the health-care legislation that's moving through Congress, these and other benefits would take effect quickly and should produce a noticeable impact on consumers, according to many independent analysts and Democrats.
"This would be a substantial package that could probably be quite helpful," said John Holahan, director of the health-policy center at Washington's Urban Institute, a research group.
Paul Ginsburg, president of the Center for Studying Health System Change, called help for Medicare prescription-drug beneficiaries and people with pre-existing medical conditions "highly visible improvements for individuals already highly aware of the shortcomings of the existing system."
Leaders in the House and Senate are expected to reach agreement on the legislation soon, with the aim of having a final bill ready for President Obama's signature this month.
The two bills have several similar immediate-impact features. Both would bar lifetime limits on coverage, starting six months after the measure is enacted.
They also would expand community health centers, where consumers could go for care, and would require health plans to allow young people, up to age 26 in the Senate bill and 27 in the House bill, to stay on their parents' policies. Age requirements now vary by state.
Both bills provide immediate aid for the uninsured. The Senate bill includes $5 billion to help finance a temporary program that would provide coverage to uninsured people with pre-existing conditions, effective 90 days after the bill is signed.
The House bill also would create a temporary insurance program for those who have trouble buying coverage, effective immediately upon passage.
The steps that both houses of Congress want to take to close the Medicare prescription-drug coverage gap, or "doughnut hole," are clearer. This year, Medicare prescription-drug beneficiaries who don't receive the program's low-income subsidy or who aren't enrolled in drug plans that provide "gap" coverage must pay the full prices of their drugs once expenditures by their plans and them total $2,830.
Then, once a beneficiary's out-of-pocket costs for the year total $4,550, Medicare catastrophic coverage kicks in and the beneficiary pays only a small co-payment for each drug until the end of the year. The $2,830 figure doesn't include the plan's monthly premium, which the beneficiary must continue to pay even while in the coverage gap.
Both bills would shrink the gap by $500 immediately, and would provide 50 percent discounts on brand-name prescriptions for most recipients.
The Senate bill has other provisions. After 2014, insurers couldn't reject anyone because of pre-existing conditions, and the bill would bar companies from turning down any children beginning six months after enactment.
It also would allow small businesses — generally those with fewer than 25 workers — to get tax breaks, beginning this year, if they help their employees buy coverage.
