Here's the immediate effect:
Those who don't have ins will have to buy insurance or pay a $5000 fine(tax)
Those who are employed part time will ether be offered employer sponsored ins that will be deducted from their pay or the company will choose to pay a fine(tax), in which case you will not get any coverage.
Those who have ins may lose their coverage because their employer may choose to drop their coverage. Then you'll have to apply with the state for coverage. This has not been set up yet and won't be till 2014.
Those who pay for their own coverage will suffer the least meaning the rich won't be effected by this in the short term. Maybe in 10 years we will have a single payer system and everyone will be stuck with.
What the bill does is make it easy for government to tax anything that relates to health, air, water, food, energy, and transportation.