Many Democrats in Congress are unhappy that President Obama and party leaders decided that the insurance overhaul had to fit within a $900 billion limit, while no ceiling has been placed on Afghanistan and Iraq war costs.

By 2019, the House insurance reform would cut $570 billion from the Medicare program which covers people age 65 and old, according to Richard Foster, the chief actuary of the federal agency that runs Medicare and Medicaid.

A major topic in the House insurance reform bill is how the federal government can identify and try to reduce health disparities, which the bill defines as differences among groups of people in the prevalence of disease, in disease outcomes, or in access to medical care.

A central focus of the debate over health insurance legislation is its effect on future budget deficits. The deficit in fiscal year 2009 was $1.4 trillion, or 9.9 percent of Gross Domestic Product, the highest deficit as a share of GDP since 1945.

The White House and Senate Democrats have turned to a proposal to tax breast implants, tummy tucks, wrinkle-smoothing injections and other procedures as they search for ways to pay for costly health care overhaul plans.

The bill passed by the House includes an amendment sponsored by Rep. Bart Stupak, D- Mich.

Medicare pays the medical bills for nearly 40 million Americans age 65 and older and 7.4 million disabled Americans. About 80 percent of Medicare's funding comes from the taxpayers, both from income taxes and from the 2.9 percent Medicare payroll tax.

Members of Congress and members of congressional staffs get their insurance coverage through the Federal Employees Health Benefit Plan which offers a variety of private-sector policies from which to choose.

In order to raise some of the revenue to pay for providing health care to uninsured people, the House bill would impose a 5.4 percent surtax on joint tax returns with adjusted gross income of $1 million or more, or $500,000 for single people.

Some people wonder why a new federal program is needed since two big ones, Medicare and Medicaid, already exist. Together those two programs spend more than $700 billion a year for the medical care of more than 85 million Americans.

Some 8.2 million Americans age 18 to 24 were uninsured in 2008, according to the Census Bureau. This cohort had the highest rate of being uninsured -- 28.6 percent -- of all age groups.

Any insurance overhaul that becomes law will likely include a requirement that each person buy insurance if he or she isn't already covered.

A primary purpose of the insurance reform has been to expand the number of insured people.

In the vote Saturday night on the Democratic bill to overhaul health insurance, 219 out of the 258 Democratic members of the House voted 'yes.' One Republican, Rep. Joseph Cao of Louisiana, also voted 'yes.' The bill needed 218 votes to pass.

The House voted Saturday to add to its bill an amendment sponsored by Rep. Bart Stupak, D-Mich., and others, that prohibits individuals who receive federal insurance subsidies from purchasing any plan that pays for elective abortions.

Medicaid, which provides medical insurance to low-income Americans, is funded jointly by the states and the federal government. Wealthier states bear a bigger share of their Medicaid costs than poorer states do.

The Congressional Budget Office uses three measures to estimate the cost of insurance legislation. One is gross cost, which means the amount of a bill's new spending and new tax breaks.

Sen.

In the struggle over health insurance reform, the primary goal of many Democrats has been to enact a government-run insurance plan, in addition to the existing ones, Medicaid and Medicare, which are open only to the poor, the disabled and those age 65 and older.

The bill unveiled by House Speaker Nancy Pelosi Thursday would do many things — create a requirement for most Americans to obtain health insurance; set up insurance "exchanges" through which people could get subsidies to reduce the cost of coverage; expand eligibility for  …

Many insurance plans do not cover alternative treatments, such as naturopathic medicine.

Medicare is the program which pays the medical costs of 38 million Americans age 65 and older and 7.4 million disabled Americans. The average benefit per enrollee in 2008 was about $11,000, with total spending at $470 billion.

Democrats who want to overhaul the nation’s health insurance system cite Theodore Roosevelt as their precursor. A national health insurance system, said Sen.

Estimates of the 10-year cost of the Democrats' insurance overhaul range from about $800 billion to $1 trillion.