Health care reform legislation passed Saturday by the House of Representatives is the “high water mark” for people with disabilities, advocates say, but the measure still has a long way to go as all eyes turn to the Senate, which must consider the legislation next.

The House bill, which comes after months of negotiation and heated debate, requires health insurers to offer more comprehensive coverage and to provide insurance to a wider swath of the population including those with pre-existing conditions. The measure would also create new long-term care options and expand Medicaid.

“The fact that the package has paid such attention to people with disabilities is very significant,” says Marty Ford, chair of the Consortium for Citizens with Disabilities.

Here’s a closer look at what the House health care bill would do:

• Level the playing field: Pre-existing conditions would be a thing of the past as would annual and lifetime coverage caps. For those currently unable to get insurance because of a pre-existing condition, the bill would require the immediate creation of a high risk pool to cover this population before insurance reforms are fully implemented.
• Long-term care: The House voted to support the Community First Choice Option which gives states the option to receive more federal matching funds to support individuals with disabilities who live in the community. In exchange, participating states must eliminate caps on the number of individuals who can live in the community. Initially, advocates wanted health care reform legislation to include a mandate, but they say that giving states this option is an important first step. Also on the long-term care front, the House bill includes the Community Living Assistance Services and Supports, or CLASS Act, which would create a government long-term care insurance program that workers could buy in to.
• Coverage expansion: Insurance plans would be required to cover rehabilitation and habilitation services, durable medical equipment, prosthetics, orthotics and related supplies, vision and hearing services and behavioral therapy. Mental health coverage would also be expanded for individuals covered under large group plans.
• Medicaid boost: The federal government would increase funding for Medicaid, while expanding eligibility for the program and increasing reimbursement rates to doctors. This is particularly significant for people with disabilities, says Laurel Stine, director of federal relations for the Bazelon Center for Mental Health Law. By extending Medicaid to individuals with a family income of up to 150 percent of the federal poverty level, including single childless adults, many of whom have severe mental disabilities, the House confirms the value of the Medicaid program to give low-income, vulnerable Americans the comprehensive services and supports they need to get better and to live happy, healthy and productive lives.”
• Accessibility: Disability would be added to the list of health disparities so that research can be conducted regarding the accessibility of health care to this population. Moreover, standards would be created for accessible medical equipment like exam tables and x-ray machines.

While the House passage is a significant step, health care reform must now be considered by the Senate, which is shaping up to be contentious. Senators have not yet revealed a final version of their bill, but it is expected to differ significantly from the House version. In particular, the two plans have different approaches to paying for the proposal and many Senators are opposed to including a public option, or a government backed insurance option, like the House.

Already, Senate Majority Leader Harry Reid, D-Nev., hinted that the full Senate may not be able to take up health care reform legislation until next year. But on the heals of the House vote, President Barack Obama urged Senators to work toward completing a bill so that it can be signed into law before the end of the year.