The Affordable Care Act, better known as Obamacare, has created controversy among both supporters and opponents. Expect the arguments to get even louder once taxpayers start having to pay for it.
In just a couple of months, two tax increases tied to Obamacare will take effect. With the provisions squarely aimed at high-income earners, they're almost certain to polarize the debate over health-care reform even further.
Two 'New' Obamacare Taxes
The new taxes are aimed at boosting and extend the reach of Medicare payroll taxes for taxpayers above certain income levels.
Under current law, the government charges a tax of 2.9% on wages and self-employment income. For employees, your employer covers half of that tax, and the other half is withheld automatically from your paycheck.
That rate will soon be raised to 3.8% for single filers who have earnings of more than $200,000. For joint filers, the limit is $250,000. Moreover, the entire additional 0.9% will come out of your pocket.
Single filers can expect their withholding to be done correctly by their employers, but joint filers may need to pay additional tax out-of-pocket because their respective employers won't know how much the couple earned in total.
The other new tax, known as the Unearned Income Medicare Contributions tax, extends the 3.8% Medicare tax beyond wages and earnings to include investment income. In this case, the IRS will look at all of your income and determine how much of it pushed your income above the $200,000 limit for singles or the $250,000 limit for joint filers. To the extent that investment income reaches above those limits, you'll have to pay the new 3.8% tax on that amount. For instance, if you're single and had income of $205,000, $15,000 of which came from investment income, then you'd pay the new investment-income tax on the $5,000 that pushed your income beyond the $200,000 limit.
Don't Expect Romney to Save You
Of course, the presidential election could play a pivotal role in the future of health-care reform, as Republican candidate Mitt Romney has vowed to repeal Obamacare if elected. Yet unless Democrats lose not only the Oval Office but also their control of the Senate, Romney won't have the power to fulfill his promise unilaterally. And even with GOP control of Congress and the White House, a filibustering Democrat minority in the Senate might make repeal a tall order.
High-income taxpayers need to assume that the new Obamacare taxes will take effect as planned and use favorable provisions like retirement accounts to protect their incomes from the tax.
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Obamacare Taxes: How the Changes Will Impact Your Income
Myth 1: Obamacare is being partially funded by a $500 billion cut to Medicare.
Reality: Funding for Medicare will actually increase over the next 10 years. However, the rate of increase will drop, partially due to more aggressive prosecution of fraud and a reduction in overpayments to insurance companies.
In fact, the ACA has already increased funding to Medicare in some ways. It has increased the minimum rebate on drugs, extended coverage to smaller hospitals, set up public health screenings for Medicare recipients, and it introduced a discount to help cover the Medicare "doughnut hole" on prescriptions. The plan is to eliminate the doughnut hole by 2020.
Myth 2: Obamacare will introduce "death panels" that will severely ration care and will force elderly patients to commit suicide or submit to euthanasia.
Reality: Introduced by Sarah Palin in 2009, the idea that health care reform will lead to euthanasia is one of the most persistent lies myths surrounding Obamacare. There have been several versions of this claim; the most recent is that the Independent Payment Advisory Board will ration care and will make end-of-life decisions for patients.
In truth, the IPAB is basically powerless. It will make health care policy recommendations to Congress, which will then have the ability to pass or reject those suggestions. The president, in turn, will have the power to veto Congress' decisions -- as he can with any other piece of legislation.
Ironically, death panels already existed before health care reform -- but they were run by your insurance company. Insurers have regularly denied coverage for pre-existing conditions, canceled policies on sick patients, refused to pay for vital, life-saving operations, and otherwise made financially-based decisions about who would get to live and who would be left to die.
According to one congressional report, three insurance companies -- UnitedHealth (UNH), WellPoint (WLP) and Assurant (AIZ) -- saved $300 million by canceling policies on over 20,000 sick people over a five-year period. The new health care law will make many of these practices illegal. In other words, rather than creating death panels, Obamacare will actually abolish them.
Myth 3: Obamacare will force the middle class to pay for health care for poor people and illegal immigrants.
Reality:Many health care reform critics have argued that America already has a universal health care option: emergency rooms. After all, the argument goes, when people without insurance find themselves in desperate need of medical attention, they can always find help in ERs, which are required by law to open their doors to anyone in need of care. Consequently, critics claim, poor people can get health care without passing the charges on to the middle class.
But this health care isn't free -- in fact, standard treatment through a primary care physician is far cheaper than crisis care in an ER. Many hospitals aggressively bill emergency patients -- and their insurers -- to recoup the inflated costs of such care. Even so, they come up short.
So who covers the shortfalls? Well, a significant source of hospital funding is taxes. For the rest, hospitals make up their ER losses by inflating the prices that insured customers pay -- and according to the Center for American Progress, this amounts to a $1,100 yearly "hidden tax" on health insurance. Put simply, emergency room care is already funded by taxpayers and the insured middle class.
Granted, Obamacare will extend Medicaid to lower income families, and will subsidize health insurance for people who make up to 400% of the poverty line. On the other hand, it will also require people who can pay for health insurance do so, and will more aggressively prosecute Medicare fraud. More to the point, it will levy a 0.9% tax on households making more than $200,000 per year, and will increase taxes on medical machinery manufacturers, pharmaceutical companies, and insurers. Thus, it will, in all likelihood, actually reduce the burden on middle class families.
Myth 4: Obamacare is a socialist program.
Reality: Socialism is a system under which the government directly runs a nation's industries. Under this standard, New Deal programs like the Works Progress Administration and the Tennessee Valley Authority could, arguably, be considered socialist. After all, they represented instances in which the government directly employed people to build and administer power plants and other public works that generated income.
Obamacare, on the other hand, will work through private companies. Rather than directly providing health insurance, either through a national program or through some sort of public option, the government will require that people deal with private insurers. Far from competing with private industry, the health care law will likely give it a lot of new customers.
Myth 5: Obamacare will bankrupt small businesses by making them pay for their employees' health insurance.
Reality: The basis of this claim is a requirement that companies with more than 50 "full-time equivalent" employees must offer affordable health insurance to their workers. The insurance in question must not cost more than 9.5% of the employee's annual salary and must pay for at least 60% of covered health care costs.
A big part of the disagreement over the impact of this requirement lies in how you define a "small business." According to the government, the cutoff line between a small and a large business is 50 "full-time equivalent" employees. In other words, if a company's weekly work load totals more than 1500 hours -- the equivalent of 50 employees working for 30 hours per week -- then it is, officially, a large business, and is required to provide a competitive health insurance option.
As a side note, Obamacare contains a pretty significant tax break for businesses with up to 25 employees that offer health insurance.