For some time now, James Stockton has been stockpiling insulin and testing supplies for the day when he and his type 1 diabetes would no longer be covered by his parents' health insurance policy.

But Stockton, just a few days shy of his 23rd birthday, now has a reprieve. The BYU junior is one of thousands of Utahns who will be affected by expanded benefits under a historic health care reform bill signed Tuesday by President Barack Obama.

By the end of the year, insurers will be required to keep young adults on their parents' health care plans until they turn 26, and insurers will no longer be able to deny coverage to children with pre-existing conditions. The bill also provides tax credits for small businesses that provide health insurance and will give seniors facing high costs a $250 Medicare rebate this year.

"I've been worried," said Tanya Wilson, a 25-year-old BYU-Hawaii student who has been living without health insurance for five years.

Wilson was dropped from her father's policy when she moved away for college. She's been unable to afford her own health insurance because she was diagnosed with a hormone imbalance.

"It's just too expensive," Wilson said. "If I have to choose between my groceries and rent and health insurance, I'm going to take that risk."

While the passage and signing of the bill has been met with fiery opposition from Republicans, health care proponents say reform was badly needed.

"We hear stories every day," said Jessica Kendrick of the nonprofit Utah Health Policy Project. "Everybody has a family member or friend or neighbor who has some kind of health care story. These reforms are finally addressing those barriers that Utahns are facing every day.

"I think we can't let the perfect be the enemy of the good," Kendrick said. "This is going to be a process. A lot of major pieces of reform aren't implemented for four years. There's going to be time to get it right."

For Dulsi Beaslin, the bill's small-business tax credits that help cover up to 35 percent of premiums will allow her to afford insurance for the young women who work at her Holladay nail salon.

The new requirements surrounding pre-existing conditions mean Beaslin's children finally can be covered for their asthma and juvenile arthritis.

"We were considered uninsurable, as far as we could afford," she said. "We had been denied many times. It will be nice when we (Beaslin and her husband) can be covered as well, but at least my children will have insurance."

Under the bill, insurers will no longer be able to exclude adults' pre-existing conditions by 2014.

That's good news for Alexis Waters, who has been afraid to change jobs or insurance since being diagnosed with melanoma last year.

"If I were to get let go of work and I couldn't afford COBRA, then if I had it lapse, I would not be covered for it ever again," said Waters, whose quarterly scans and tests would run her thousands of dollars each year if she were uninsured.

The federal Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows workers and their families who lose their health benefits to purchase group health coverage provided by the plan under certain circumstances, though often at a higher cost.

"To not have that as a stress to worry about is amazing," Waters said.

Danny Quintana, a Salt Lake City attorney who lost use of his legs when he was stricken with transverse myelitis 25 years ago, has been uninsured for years.

It's meant carefully managing his lifestyle and money and skipping trips to the doctor, Quintana said.

"I got really sick with that swine flu over the holidays," he said. "I was in bed for six days, and really, as sick as I was, I couldn't go to a doctor. I didn't want to pay thousands and thousands of dollars, so I toughed it out."

At Utah's anti-poverty groups, the mood is upbeat.

"We're thrilled," said Sheila Walsh MacDonald, health care advocate with the Salt Lake Community Action Program. "Many of our lower-income clients will benefit greatly."

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To qualify as an adult for Medicaid health coverage under current guidelines, MacDonald noted, recipients must be in the "very, very poor" category.

Starting in 2014, Medicaid will be expanded to adults whose income is 133 percent above the federal poverty level, up from 50 percent.

Once Utahns understand the details of the bill, such as incentives for small-business employers to be able to offer insurance, "I don't think the bill will be frightening to people," she said.

e-mail: afalk@desnews.com; jarvik@desnews.com