The bill contains provisions that will go into effect on June 21, 2010 and September 23, 2010. Also, the additional provisions will go into effect in 2014. Title I of H.R. 3590 will ensure quality affordable health care for all Americans by eliminating discriminatory practices by health insurers such as pre-existing condition exclusions. Title I also extends dependant coverage up to age 26, caps insurance companies non-medical expenses, and prevents unfair termination of insurance policies. Title II expands eligibility for Medicaid to lower income persons and assumes federal responsibility for much of the cost of this expansion. These bills provide enhanced federal support for the Children’s Health Insurance Program, simplify Medicaid and CHIP enrollment, and improve Medicaid services. Title III will strengthen the quality of healthcare by establishing The Physician Quality Reporting Initiative (PQRI) which is a value-based purchasing program for hospitals that link Medicare payments to quality performance. Title IV puts into place a new interagency council to promote healthy policies and to establish a national prevention and health promotion strategy. Title V will encourage innovations in health care workforce training, recruitment, and retention, and will establish a new workforce commission. Title VI creates new requirements to provide information to the public on the health system and promotes a newly invigorated set of requirements to combat fraud and abuse in pubic and private programs. Title VII allows certain hospitals and treatment centers to receive discounted and/or generic drugs to aid their budget. Title VIII establishes a new, voluntary, self-funded long-term care insurance program, the Community Living Assistance Services and Support (CLASS)…