ImageAffordable insurance for low- and middle-income Americans is the new principle of the health reform law. However, keeping to this principle is not going to be free.

The federal government is now expected to spend around $1 trillion in the next decade to finance coverage and to increase eligibility for Medicaid. And in order to pay for it, the new law imposes multiple cuts in spending meant for federal health care, including a number of fees, taxes and penalties. These taxes will have to be paid by the companies working in health sector and hospitals, as well as by consumers and employers.

Those who will participate in footing the bill include high-income families, those who get solid health benefits at work, as well as those who prefer being uninsured and those who like an indoor tan.

Entering into force in 2013, the individuals earning more than $200.000 per year, or $250.000 if married, will have to pay more to Medicare. In fact, the new health reform project influences the Medicare tax in two ways: it implies surtax on salary income above an established level, and it imposes additional Medicare tax on investment revenue. Some rich families will only have to pay one of these taxes, and others will have to pay both.

In the following year, rich individuals will be paying additional 0.9% points on their earned revenue above $200.000, or $250.000 if married. This is in addition to the 1.45% they now pay on all of their salaries.

Get Insured Or Pay Penalties

Concerning those with investment revenue, they can also become subject to an extra 3.8% tax on at least a part of their dividends and capital gains. Moreover, according to a mandate that will be launched in 2014, Americans will have to be insured or pay penalties. The amount of these penalties increases annually from 2014 to 2016 and will thereafter depend on the inflation level. The penalty is expected to be no more than $285 for a family by 2014, or 1% of revenue, whichever is more convenient. However, the cap will rise to $975 in 2015, or 2% of revenue.  And the penalty is expected to grow up to $2.085 for one family by 2016, or 2.5% of revenue, whichever is better.

However, the new reform involves a number of exemptions. For example, individuals with rather low incomes, who often apply for advance loans to stay afloat, or who participate in certain religious communities, will be free from the penalties. Those who benefit from insurance premiums that exceed 8% of family revenue will also be exempted from penalties, even after considering federal subsidies and employer contributions.

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