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The three health insurance reform plans approved by congressional committees are unlikely to make insurance affordable for low- and moderate-income families. Under plans in the bills, subsidies would be available through a “gateway” or “health exchange” to those not covered by an employer, Medicare, or Medicaid. The plans vary considerably in amount of subsidy and their impact on families. In nearly all instances, premiums would be more costly to families than under the Massachusetts plan, which covers about 169,000 people (while an equal number remain uninsured).