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The current version of health care reform legislation is so roiled in controversy that it's not clear it will be passed any time soon. However, if it is passed, one of its most controversial aspects - mandatory purchase of health insurance - will become law. For many people, this new requirement is considered to be a violation of their civil rights. Health insurance rates have been rising and health care spending is not expected to slow down anytime soon.

America's current health care system is the most expensive in the world, even while millions (between 30 and 46, according to the Office of Management and Budget) of citizens have no health insurance. Their lack of insurance is considered to be a big part of the inefficiencies in the current health care system: no health insurance makes people less inclined to engage in preventative care, which results in very expensive emergency room visits for problems that went much further than they ever needed to.

(Read about the effect of the bill for seniors and young adults)

Legislation is Supposed To Help Healthcare

To remedy this structural inefficiency, Congress is proposing legislation that would force people to get health insurance or end up paying a fine. This would be the first time in American history that health insurance is required of all taxpaying adults. People who don't buy health insurance would be subject to a $1,500 penalty. The legislation has its supporters and its detractors. (Read about how a Republican could totally change the game)

Supporters of mandatory health insurance compare it to being required to participate in Social Security, or have car insurance. People who can't afford to buy their own health insurance would get government subsidies. This includes both the working poor and the unemployed (the latter currently totaling 15,000,000, according to the Department of Labor).

The Civil Rights Problems with the Healthcare Bill

Detractors, however, claim that forcing people to buy health insurance is an unconstitutional government intrusion into Americans' lives, and one that is not authorized by the Constitution.

Constitutional scholars are just as divided because comparable legislation is so rare. At the core of the debate is the Constitution's Commerce Clause, which regulates interstate commerce. Those who think mandatory health insurance is constitutional point to the fact that health care is an enormous part of our economy and hence falls under the Clause's purview. Detractors argue that that's too liberal of an interpretation, and ask why, under that logic, the government "couldn't mandate daily calisthenics" or anything that it wanted.

Passage of health care reform may be unclear right now, but legal challenges to mandatory health insurance are almost guaranteed to follow should the bill become law.

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All Americans are concerned about health care reform. People who already have health insurance are worried that theirs might change or be reduced, while those who don't are worried that whatever they get won't be enough. Everyone's heard the horror stories about lives derailed by lack of health insurance, medical bankruptcies and worse, and the stakes are very, very high.

While it's not clear that the current health care reform bill will ever be made law - it's currently stalled in the House of Representatives (and may change because of Scott Brown) - many people are wondering what will happen if it does. Two groups which could be greatly impacted are adults and seniors. Go Insurance Rates takes a look at how health care reform could impact these age groups.

Read our article about youth and the healthcare bill.

Adults Won't See Many Changes from Employers

Adult American men and women who get their health insurance from their employers, Medicare, Medicaid, the VA or privately will continue to receive health care the way they always have.

Big changes could appear in the way health insurance is regulated. For example, under the current legislation no one could ever be denied health insurance for having a pre-existing condition. Under current health insurance practices, someone who has suffered a major illness in the past could be denied insurance coverage because they'd be too much of a risk. If the bill passes, the "uninsurable" will no longer have to go without health insurance because of a pre-existing condition.

Individuals and small businesses could also find their insurance on brand-new "insurance exchanges." These government-regulated market places would theoretically boost competition between insurance providers and keep costs down.

Seniors and "Death Panels"

Many senior Americans are worried about health care reform because they fear it could change the way they receive Medicare. They've also heard a lot about so-called government-run "death panels" which would pressure seniors to make difficult decisions about ending their lives.

According the National Council on Aging, the health care reform bill will not cut any Medicare benefits. However, payments to doctors will be reduced by about 21%. Critics worry that this payment reduction will reduce Medicare recipients' access to quality health care as more and more doctors decline to work with the program.

Concern with "death panels" is also a factor for seniors. High-profile critics like former Alaska governor Sarah Palin claim that health care reform will send seniors to government-run panels which will decide whether they (as well as the disabled) should receive medical treatment. The claim has been widely debunked as false, however.

Seniors enrolled in Medicare Advantage may seem some changes in the way they get health care. Medicare Advantage, which allows participants to enroll in private health plans, was originally implemented to create cost-savings. However, that has not panned out, and Medicare Advantage is now subsidized by the government. As part of its cost-saving measures, health care reform legislation would reduce the amount of subsidies given to Medicare Advantage. The result could see many seniors currently enrolled in Medicare Advantage switching over to traditional Medicare.

As we get older we become more and more concerned with our health, and rightly so. It follows, then, that our health care becomes more important to us when we enter middle age and beyond. Because of this, there may not be demographic groups with more at stake in the debate over health care reform -- whether it passes or not -- than adults and seniors.

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