On Saturday, the House of Representatives passed the Affordable Health Care for America Act (H.R. 3962) by a vote of 220-215. Rep. Anh “Joseph” Cao (R-La.) was the only Republican House member to vote in favor of this healthcare overhaul legislation, while 39 House Democrats dissented.

Among other things, this nearly 2,000-page bill requires most individuals to purchase health insurance, and most large employers to either offer their employees health insurance or contribute funds (in the form of an 8 percent payroll tax) on their behalf to help subsidize the coverage they would instead obtain through health insurance exchanges. Smaller employers would either be subject to a smaller annual payroll tax, or be exempt from this “pay or play” requirement entirely. The bill also creates a public health insurance option that would be available within the exchange. Additionally, almost all employer-sponsored health plans would be required to meet essential benefit package requirements beginning in 2018. This legislation also imposes a number of restrictions on insurance providers. For example, this bill would prohibit preexisting condition exclusions in health insurance plans, lifetime limitations on benefits, and the practice of charging higher health insurance rates based on factors such as gender or health status.

The Congressional Budget Office (CBO) recently estimated that under the terms of this bill, approximately six million additional people would obtain health insurance coverage from their employers by the year 2019. The CBO’s preliminary analysis also projects that employer penalty payments under the pay or play system created by this bill would amount to about $135 billion collected from 2013 through 2019.

Despite this victory for House Democrats, the healthcare reform debate is far from over. The Senate still needs to pass its own healthcare bill. The America’s Healthy Future Act (S. 1796) cleared the Senate Finance Committee last month.  This bill, which neither imposes as stringent employer mandates nor includes a public insurance option, is currently being merged with the Affordable Health Choices Act (S. 1679), a bill passed by the Senate Health, Education, Labor and Pensions (HELP) Committee this summer that does include such provisions. Assuming the Senate passes its version of the healthcare bill, the House- and Senate-approved bills would need to be reconciled and voted on again by both chambers. This process could very well extend into the new year.