Obama's Health care reform bill 101: Who will pay for reform?

If the health care reform vote succeeds today, the $940 billion bill would be the biggest change to domestic policy in a generation. The rich and the health industry would pick up most of the tab.Among other things, it would provide or subsidize health coverage for 32 million currently uninsured people.

Higher Medicare taxes on rich people

If you are an individual making more than $200,000 a year, or a married couple making more than $250,000 a year, get ready to pay more for your Medicare if health care reform passes.
First of all, your Medicare Part A (that’s hospital insurance) tax rate would be increased by 0.9 percent, to 2.35 percent. Second, the bill creates an entirely new tax of 3.8 percent on unearned income (dividends, interest, stuff like that) for people in those same income brackets.
The good news is that this would not take effect until Jan. 1, 2013. And it is a big money raiser, truth be told. The Joint Committee on Taxation estimates this would bring in $210 billion between 2013 and 2019.

New tax on expensive health insurance

They used to call this the “Cadillac tax,” but it’s been pared back enough so it might better be called the “Chevy with leather and A/C” tax.
The health care bill would impose an excise tax on insurers of employer-sponsored health plans that cost more than $10,200 annually for individual coverage, or $27,500 annually for family coverage. The tax in question would be 40 percent of the cost of the plan that exceeds those dollar thresholds.
This tax would not kick in until 2018. The JCT figures it would bring in around $32 billion in its first two years.

Fees on health care industries

The Obama administration figures it is only fair to slap some fees on health care industries, since they’d be getting lots of new customer if health care reform passes. So after negotiations with some big sectors, the White House struck a number of deals.

* Drug manufacturers would pay the US a total of $16 billion between 2011 and 2019.
* Health insurers would pay $47 billion over the same period.
* Medical device manufacturers would pay a 2.9 percent excise tax on the sale of any of their wares, beginning Jan. 1, 2013.

The tanning tax

OK, it’s not a big money raiser, but we could not resist mentioning that health care reform would establish a tax of 10 percent on indoor tanning services. (Outdoor tanning services remain untaxed, of course.) This would raise $2.7 billion between 2010 and 2019.

Medicare cuts

Government payments to Medicare Advantage – plans run by private insurers that are an alternative to traditional Medicare – would be reduced by $132 billion over 10 years under the health care reform bill. (Those plans now get around 14 percent more per person than traditional Medicare does.)
Medicare payments for home health care would also be reduced by $40 billion over 10 years. And cuts in certain payments to hospitals would raise another $22 billion by 2019.