WASHINGTON — House Democrats are looking at big health care changes, including federal aid to help families earning up to $88,000 pay for insurance and a requirement that all must carry coverage.

A document obtained by The Associated Press shows the plan being written by the House Energy and Commerce Committee would also require employers to offer coverage to their full-time workers, or pay a percentage of their payroll to the government.

The House committee summary is a first look at where Democratic leaders in that chamber are headed as they try to meet an ambitious goal of passing a bill by the end of July.

President Barack Obama has said the final legislation must rein in costs, guarantee choice of health plans and medical providers, and ensure that all Americans have access to affordable coverage. But he's leaving it to Congress to try to work out the details.

The three-page summary says the House plan would "minimize disruption" for people who already have coverage and give them the "ability to keep what you have." All Americans would be protected by an annual limit on out-of-pocket costs, a safeguard already in the best private plans.

Yet proposed changes would affect everyone, particularly since workers are now more likely to change jobs — and even careers. The moves jeopardize job-based benefits.