Democrats crafted a major overhaul of health care regulation so that voters would see some of its effects soon, even though some major changes will take several years to put into place.

One of the changes that goes into effect in 2010 is allowing young adults to continue on their parents policies. The law allows dependents up to age 26 to remain on plans, one year longer than Obama promised during the campaign. The U.S. Department of Health and Human Services will need to draw up regulations for the rule before it takes effect, but that should be within six months of enactment.

Also included in the bill is a requirement for all individuals to obtain health insurance, otherwise known as the individual mandate. During the campaign, Obama supported a mandate for children but not adults. Obama changed his mind while Congress was drawing up the legislation, so he signed a bill that went even further than his campaign promise. The individual mandate is scheduled to take effect in 2014.

Attorneys general in several states have pledged to challenge the constitutionality of the new health care law, specifically on the basis of the mandate. If those lawsuits are successful -- or if Republicans succeed with their effort to repeal the health care plan -- we'll re-evaluate this item. But for now, Obama's campaign promise is the law of the land, so we rate this Promise Kept.

After months of talking about health care reform, the U.S. House of Representatives introduced major legislation to overhaul the nation's health care system. House Democrats unveiled the 1,000-plus-page bill, called America's Affordable Health Choices Act of 2009, on July 14, and it includes most of President Barack Obama's key proposals on health reform.

One of Obama's promises was to require children to have health insurance. The House bill goes a step further, establishing an individual mandate that requires all adults and their dependents to have insurance, or pay additional tax. Obama has said he will support the mandate as long as there is a hardship clause for people truly unable to afford health insurance. It's not clear yet whether a hardship clause would exempt children. (It seems likely such children could qualify for the State Children's Health Insurance Program.)

To be sure, there's a long way to go — maybe months — before the bill becomes law. It has to pass the House and get through the Senate, where many changes could be made.

Nevertheless, the bill marks significant, measurable progress on Obama's promise, and we rate it In the Works.