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Tax implications of health care reform legislation

Posted by Jamie Downey  March 24, 2010 08:51 AM

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Whatever your thoughts are on the health care legislation that has passed, everyone has to agree that it is expensive. The Congressional Budget Office estimates that the legislation will cost $950 billion over a ten-year period.

Health care reform comes in two pieces of legislation, The Patient Protection and Affordability Act (the Original Bill) which was signed into law by the President yesterday and the HR 4872 Health Care and Education Affordability Reconciliation Act of 2010 (the Amendment) which passed the House and is expected become law in the near future. To offset the costs of government's increased role in health care, there are several tax increases being imposed (or as politicians like to say "revenue provisions"). Here are a few, but certainly not all, of the more significant "revenue provisions" that I saw while looking through the texts' of the legislation:

Section 1002 of the Amendment – Individual responsibility: Starting in 2014 everyone will be required to maintain health insurance. If you go without insurance, you will be subject to a tax of $695 per year.

Section 1003 of the Amendment – Emploer responsibility: Large companies will be required to provide health insurance as a benefit to its employees. Companies that do not provide this benefit will be imposed a tax of $2,000 a year per employee.

Section 1401 of the Amendment – High cost plan excise tax: Starting in 2018, high cost health insurance plans will be subject to a tax. Plans for single persons that cost in excess of $10,200 and family plans that cost in excess of $27,500 are in this sections crosshairs. The excise tax rate on incremental costs will be 40 percent. In an attempt to appease union dissent, this tax will not be assessed on the individual but will be assessed on the insurance company providing the plan. Ultimately, the costs will still be burdened by the purchaser.

Section 1402 of the Amendment – Medicare tax: Medicare tax will now be assessed on investment income for families making in excess of $250,000 and for singles making over $200,000. Investment income includes interest, dividends, capital gains, rental income and royalties. In the past, Medicare taxes had been assessed on wages only. Earn one dollar of investment income while you are over the threshold limits and you will incur this tax. This tax will commence January 1, 2013.

Section 9015 of the Original Bill – Medicare tax: In addition to the expansion of Medicare tax on investment income as noted in Section 1402 above, the Medicare tax rate has also increased. This tax increases by a third, from 2.9 percent to 3.8 percent.

Section 1404 of the Amendment – Brand name pharmaceuticals: Starting in 2011, the pharmaceutical industry will be subject to a $2.5 billion annual excise tax. The annual excise tax increases in subsequent years, rising to $4.2 billion in 2018. The tax is assessed based on a companies market share and is non-deductible for federal tax purposes.

Section 1405 of the Amendment – Excise tax on medical device manufacturers: Sales of medical devices will be subject to a 2.9 percent national sales tax. This will apply to sales occurring after December 31, 2012.

Section 1406 of the Amendment – Health insurance providers: Starting in 2014, the health insurance industry will be subject to an $8.0 billion annual excise tax. The excise tax increases to $11.3 billion annually for 2015, 2016, and 2017. The excise tax increases to $14.3 billion in 2018 and rises by inflation thereafter. The tax is assessed based on a companies market share and is non-deductible for federal tax purposes. Does anyone think this will create inflation in the health insurance premiums?

Section 9013 of the Original Bill - Modification of itemized deduction for medical expenses: For those incurring significant medical costs, your ability to deduct these expenses will be decreased. This legislation increases the adjusted gross income threshold for claiming an itemized deduction from 7.5 percent to 10 percent.

Section 10907 of the Original Bill - Excise tax on indoor tanning services: This is a sales tax of ten percent assessed on your trip to the tanning salon. This tax begins July 1, 2010.

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