The new health care reform law already has begun to take effect, affecting every health insurance plan and health insurance company as well as all American citizens. Officially called the Patient Protections and Affordable Care Act (PPACA), this new federal health legislation will change the health care landscape for good.

Many Americans cannot afford or do not carry a health insurance plan today. However, affordable health insurance is mandated for every American by 2014, including people excluded from coverage whatever the reason. Those not carrying health insurance may be fined.

Group health insurance plans will change. They had been allowed to establish lifetime and annual limits on benefit payments although companies can establish "restricted limits" through 2013. Other than misrepresentation on forms and fraud, a health insurance company will not be able to revoke insurance coverage for any reason under the new law.

Requiring all children under age 19 to be covered regardless of pre-existing conditions was another huge change affecting every American. Special and high-risk cases will transfer into insurance pools designated for their needs.

Families can cover their kids longer under the new federal health legislation. Children under age 26 may continue to be included in family insurance coverage. Retroactive cancellation of policies will not be allowed. Flexible Spending Accounts will be established to pay for over-the-counter medication except insulin.

Health insurance company plans will vary from company to company. Some companies are not included in the new health care legislation. If a health insurance plan was in effect when the health laws passed last year, the company may be able to continue its existing coverage.

All Americans will be required to be covered by a health insurance plan under the new federal health legislation. This will increase the number of insured people providing for more affordable health care costs, according to plan proponents.

If an employer has more than 50 employees, that workplace must have affordable health insurance coverage for workers or risk fines. Other employers will get tax credits if they have fewer than 50 employees and provide health insurance coverage in some form.

Federal subsidies will be available as fee vouchers or tax credits for those who can't afford the full health insurance plan purchase price. State exchanges will provide Half-price coverage for small companies will be available through state insurance exchanges through 2016.

Group health insurance plans will have to pay for emergency services, let people choose any network doctor as a primary care physician and create a coverage appeal process.

New federal health legislation will mandate changes in health insurance company plan benefit summaries and coverage explanations during enrollment and re-enrollment periods.