After months of intense political debate and decades of failed attempts, health care reform in America is now law.

President Barack Obama signed a sweeping health care reform bill into law Tuesday afternoon that will mandate that most American citizens have health insurance by 2014 — offering government subsidized exchange programs and young adults the option of staying on their parents’ health insurance until the age of 26.

Sunday evening, the House of Representatives passed the reform bill by a narrow margin of 219 to 212, with no Republican support, cementing the historic legislation that had been voted on and passed by the Senate on Christmas Eve. Obama then signed the bill into law Tuesday.

Though the final bill did not include a public option or single-payer system as some had hoped, Obama touted the legislation in the East Room of the White House on Tuesday before he sat down to sign the bill into law stating: “Today, after almost a century of trying; today, after over a year of debate; today, after all the votes have been tallied — health insurance reform becomes law in the United States of America. Today.”

The $940 billion Affordable Health Care for America Act is expected to give roughly 32 million additional Americans health insurance, in addition to making a national high-risk insurance pool for citizens who have been unable to get health insurance because of a pre-existing condition.

A House reconciliation bill, or package of changes to the Senate’s original bill voted on in December, will now go back to the Senate as soon as the end of this week. This bill will only need a majority vote, called reconciliation, to allow the compromise to clear the Senate floor and then go back to Obama.

The bill gives tax credits to smaller business as an incentive to provide employees coverage. For Americans who don’t have insurance through an employer and are still required to have coverage under the new law, there will be state-run exchanges — similar to Massachusetts’ system — and government subsidies for low- and middle-income families who earn up to 400 percent of the federal poverty level, which is about $88,000 for a family of four.

By 2014, though, if Americans don’t have insurance, they will have to pay a $95 penalty that would rise to $695 or 2.5 percent of income — whichever is higher — by 2016, according to the reconciliation bill waiting to be passed by the Senate.

The provision that allows young adults to stay on their parents’ insurance until the age of 26, regardless of whether they are a full-time student, is one of the most important pieces of the bill for students, according to John Kuder, associate professor in Cornell University’s Department of Policy Analysis and Management. The provision is expected to go into effect within six months.

But students, who are often-times healthier than older adults, will now be required to have health insurance when they graduate Kuder said, which some may not be happy about.

“The bad news is [students] will have to pay for [health insurance] even if they’re healthy,” he said. “But the good news is that if they get sick they have it. It seems to me to be only fair — the purpose of insurance is for the people who are healthy to help out those who are not healthy, so if you’re a student and healthy, you’re part of the fabric of the United States, so you’ll be paying your share, although it won’t be a big share.”

According to a statement released by Rep. Maurice Hinchey, D-N.Y., 68,000 young adults in his district, which includes Tompkins County, will be able to obtain coverage from their parents’ insurance until the age of 26.

“While this bill does not go as far as I would have preferred, it nevertheless represents the most significant and positive piece of health care reform legislation since the creation of Medicare and Medicaid in 1965,” Hinchey said in the statement. “My vote in favor of this bill is one of the most important votes I have cast during my time in Congress.”

But the Democrats’ victory is not shared across the aisle. According to The Associated Press, seven minutes after Obama signed the bill, attorneys general from 13 states sued the federal government Tuesday, claiming the reform was unconstitutional. Twelve out of the 13 attorneys general are Republican.

Don Beachler, associate professor of politics, said the Republicans’ reactions to the bill seems somewhat “hysterical.”

“To propose to repeal something the day after it’s passed is a little too soon to tell if it works or not,” he said.

Beachler said there will probably be political backlash next November, but it will be difficult to tell if it is specifically caused by health care reform. He said it is normal for the president’s party, especially one with a large majority, to lose seats in an off-year election.

“You can only lose the seats you don’t already have, so the party with fewer seats has the advantage,” Beachler said.

Critics of the country’s health care system say the reform was long overdue, though. Madelon Finkel, professor of clinical public health and director of the office of global health education at Cornell University, said she always felt the system was “inequitable.”

“We are the only developed nation in the world that does not mandate or have a provision for universal coverage and to the shame of the United States,” she said. “We’re dealing with peoples’ lives here.”

Finkel said doctors and hospitals will most likely see a surge in patients because of the additional citizens who will be insured, which may make it more difficult for patients to be seen by doctors when making appointments. She also said doctors may still not accept some insurances, but the trade-off is worth it.

“Think back, what would people do if we didn’t have Medicare? … ,” she said. “For all of these efforts the initial reaction was a no, and in my opinion that’s not appropriate, not when you are dealing with people’s health and well-being.”