The health-care bill that passed the House yesterday is funded in part by increases in Medicare and other taxes, and by a reduction in some tax breaks. Will you pay higher taxes as a result? Here's a rundown of the more-prominent changes for individual taxpayers:
• Change in healthcare Flex plans. Employees will be able to set aside less, tax-free, in employer-provided healthcare flexible spending accounts (FSAs). As of 2013, that limit will be $2,500 a year, instead of the $5,000 that many employers now allow. The $2,500 figure will be indexed annually for inflation. CLARIFICATION ADDED 3/29/10: For someone in the 28-percent tax bracket who currently maxes out this benefit, the change amounts to the loss of a $700 tax break. (Many people put in far less than the maximum.) And funds from the plans may no longer be used for over-the-counter medications, unless they're prescribed by a health-care professional.
• A higher Medicare payroll tax as of 2013. This affects individuals with adjusted gross incomes of $200,000 or more, and couples filing jointly with AGI of $250,000 or more. The Medicare tax will rise by 0.9 percent over current rates of 1.45 for employees and 2.9 percent for the self-employed. For a single person earning $300,000, for instance, that extra tax would translate to $900 a year. Incidentally, those applicable AGIs of $200,000 and $250,000 aren't indexed for inflation.
• New tax on net investment income. In the reconciliation act that now moves to the Senate, net investment income among those higher earners—including the self-employed and estates and trusts—would be taxed at 3.8 percent, starting in 2013. According to CCH Wolters Kluwer, a financial information publisher, that income includes interest, dividends, royalties, rents, and "gain from the sale of property, and income earned from a trade or business that is a passive activity." Distributions from IRAs, qualified retirement plans—including pensions and certain retirement accounts such as IRAs and 403(b) plans—would be exempt from the additional tax. (We're still waiting to hear if 401(k) plans are included on that list; the tax expert we enlisted couldn't find it in the language of the bill.) UPDATE: Mark Luscombe, principal analyst for CCH Wolters Kluwer, says 401(k) plans are exempt: "The reconciliation bill states that the term “net investment income” shall not include any distribution from a plan or arrangement described in section 401(a), 403(a), 403(b), 408, 408A or 457(b). The reference to 401(a) would also pick up 401(k) plans."
• Higher medical-expense deduction. As of 2013, you can only deduct qualifying medical expenses that exceed 10 percent of your adjusted gross income, up from the current 7.5 percent. That 10 percent deduction floor remains the same for households subject to the Alternative Minimum Tax. Households in which at least one member turns 65 as of 2013 would be exempt from this change through 2016.
Individuals who don't want to buy health insurance will be required to pay penalties that start at $95 in 2014 and increase from there. While these penalties aren't called taxes, many who oppose them construe them as such, and indeed, it'll be up to the IRS to enforce collection of the fines. Taxpayers indirectly pay for the various subsidies in the $940 billion plan.
On the other hand, households with incomes at or below four times the official poverty level are slated to receive tax credits for buying health insurance on their own. Those refundable credits are designed to ensure that those individuals and families don't spend more than a certain percentage of household income on premiums. The credits reduce households' liability for health coverage to between 2 percent and 9.5 percent of income, with those making the least paying the lowest percentage out of pocket.












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