Immediate reform — effective June 21, 2010 (90 days after enactment) National high-risk pool for individuals with a pre-existing condition who have been uninsured for the prior 6 months Premium to be set at a standard rate for a standard population Premium for older individuals allowed to be up to 4 times the premium for younger individuals Premium for tobacco users allowed to be up to 1.5 times the premium for non- tobacco users