MINNEAPOLIS, November 18, 2009 - Democratic leaders in the U.S. Senate released the long awaited health care reform bill Wednesday.

The bill is expected to cost about $849 billion over 10 years to expand coverage to millions of uninsured people, but spending cuts and tax increases would offset those costs and have a net effect of reducing the federal deficit by $127 billion over 10 years.

Here are some of the details of the bill, according to Reuters.

"INSURANCE MARKET REFORMS

* Establishes a new government healthcare insurance program that would compete with private insurers.

* States could "opt out" of the proposed government insurance plan.

* Provides for the creation of non-profit cooperatives that would provide medical coverage to members.

* Creates insurance market exchanges where individuals and small businesses can shop for insurance.

* Sets minimum benefits in four categories of insurance policies that would be offered through the exchanges.

* Starting in 2010, insurers would be barred from dropping people from coverage. A ban on excluding people for pre-existing conditions begins in 2014.

* States could band together to form larger regional exchanges.

MANDATES AND AFFORDABILITY MEASURES

* Beginning in 2013, most U.S. citizens and legal residents would be required to obtain health coverage.

* Provides subsidies for people with incomes up to 400 percent of poverty level to help buy insurance.

* Limits deductibles and out-of-pocket expenses. Limits put on a sliding scale based on incomes.

* Penalties for failure to purchase insurance would be phased in starting with $95 per adult in 2014 and $350 in 2015. By 2017, the penalty would be $750 per adult. Higher penalty imposed for failing to cover children.

* Exemptions provided for financial hardship and religious purposes.

* Young adults up to age 26 can stay on parents' healthcare policies.

* Medicaid, the healthcare program for the poor, expanded to qualify everyone up to 133 percent of poverty-line income.

* Employers not required to offer health insurance but firms with 50 or more full-time workers would pay a $750 per employee penalty if any of their workers obtain federally subsidized insurance on the exchange.

* Offers tax credits for small businesses to help provide health coverage for employees.

REVENUE-RAISING FEES AND TAXES

* An excise tax of 40 percent would be levied on insurance companies for health plans with annual premiums above $8,300 for individuals and $23,000 for families.

* For people in high-risk professions or who live in high-premium states, the excise tax kicks in at annual premiums of $11,300 for individuals and $26,000 for families.

* Raises the Medicare payroll tax to 1.95 percent from current 1.45 percent for individuals earning $200,000 or more and couples earning $250,000.

* Health insurance providers collectively would pay an annual fee of $6.7 billion starting in 2010. The fee would be allocated by companies' market share.

* Pharmaceutical companies collectively would pay an annual fee of $2.3 billion, allocated by market share.

* Medical device makers collectively would pay an annual fee of $2 billion, allocated by market share. Some items sold at retail for less than $100 would be exempted from the fee calculation.

* Imposes a 5 percent tax on elective cosmetic surgery."