Thus, the NSA cannot legally obtain the actual contents and names of calls, unless another hidden court order allows them to do just that. Verizon, along with a number of other companies, refuse to disclose the existence of pending court orders in any case.
The NSA in particular has little desire to wade through the individual calls of Americans, much less the contents of every call. Instead, they are looking for particular patterns, numbers, or a series of calls that suggest espionage or terrorism. If, for example, a number of calls originating from a particular phone or phones in New York link to Yemen, all at the same time, this can lead to NSA suspicion of curious behavior. Rather than investigating crime as evidence is found, the NSA is gathering all of the evidence, then sorting it.
For the average American, this affects nothing. While it is a major breach of privacy, a tremendous overstepping of authority, and one of the many failings of the PATRIOT Act, it does not immediately impact all but a tiny minority. Unfortunately, that means that the measures taken are likely to be forgotten within days.