Maggie Gallagher

How will this "historic" health care legislation affect you?

I've been asking a lot of people close to me this question. And the answer I keep getting is a resounding, "I don't know."

"I spent 5 minutes looking at it this morning, and I don't see anything that will help with our health care costs, which run between $550 and $3,000 a month," said an Oregon suburban mom.

"Small-business owner unclear on health care impact" trumpets a USA Today headline. For nearly 30 million small businesses with almost 60 million employees, "it seems less a matter of being for it or against it and more a matter of not understanding what it means for them," the paper reports.

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"When you're already overwhelmed with change and hear there's one more coming, you say to yourself that you'll deal with it tomorrow," says Jerry Jellison, a small-business consultant.

Pedro Alfonso, co-founder of Dynamic Concepts, a technology firm in Washington, D.C., told USA Today: "I am still a bit confused and a bit lost on some aspects of the bill and how it's going to affect me as a small business."

Well, then, what will it mean for big insurance companies like Cigna? "Unprecedented changes, all of which aren't really understood yet," David Cordani, Cigna's chief executive told The Washington Post. Even he, with his expensive lobbyists, doesn't know for sure what's in it for him?

If the CEO of a major insurance company can't tell how the bill will affect him, how can Josh be expected to know?

Josh is a former employee of mine who is one of the 8 million Americans who use a health savings account. Josh pays $260 a month for a high-deductible insurance policy that covers his wife and kids for any family medical expenses over $6,000 or more in one year. That keeps the premium affordable. He puts $5,000 in tax-deductible money into the bank each year to cover medical expenses, which includes emergency room visits, routine health care checkups, but also prescription eyeglasses, vitamins and (big-ticket item) dental care. His health savings dollars paid for the midwives his wife preferred to use in the birth of their two children, and also for some alternative medical treatments. He loves his health care saving account. And it's portable, not tied to his employment. Will he be allowed to keep it, like President Obama promised?

Maggie Gallagher

Maggie Gallagher is a nationally syndicated columnist, a leading voice in the new marriage movement and co-author of The Case for Marriage: Why Married People Are Happier, Healthier, and Better Off Financially.