Health care issue, like a buried land mine, could wind up spoiling your day, or your life

After all the controversy over the public option, people might think that everyone can sign up right away if Congress passes health reform.

Or that insurance premiums will go down.

Or that they’ll be able to shop around for insurance if they don’t like what their company offers.

Think again.

When it comes to the public option, for instance, only about 1 in 10 Americans will be eligible, mainly people who don’t get insurance through work. Only about 6 million are expected to enroll. The plan doesn’t even start until 2013.

And most people who get insurance on the job would have to stick with it. No shopping in the new “insurance exchanges” for them.

President Barack Obama and Democrats in Congress stand to reap the political rewards if they can pull off health reform, by achieving near-universal coverage, toughening regulations on private insurers and transforming the way health care is delivered.

But Democrats have glossed over nagging details of just how limited reform’s reach would be for some Americans. And if voters figure it out, experts warn there could be a political backlash.