Guess Who Gets to Pay for Health Reform (PPACA)?

Paying for a One Trillion dollar Health Care plan isn't going to be easy.  However, this point may be moot as the republicans have vowed to kill health reform where it stands.  But for the sake of argument, and assuming that the republicans aren't able to stop the de-funding of the reforms, below is a listing of taxes, penalties and fees associated with paying the bill.

1. Taxes on Tanning Services-This should raise and estimated $10 Billion.  This starts in 2010
2. Penalties on Unqualified Distributions from HSA's.  The Penalty will be increase from 10% to 20% starting in 2011 and should raise an estimated $1.4 Billion
3. Fees on Pharmaceutical Manufacturers and Importers-This takes effect in 2011 and should raise an approximate $27 Billion.
4. Comparative Effectiveness Fee-This is a fee that is going to levied on every member in a health plan ($1 the first year then $2 per year after).  Comparative Effectiveness is where a Non-Governmental Third Party gathers and disseminates health care findings to decision makers.  This goes into effect in 2012 and should raise an estimated $2.6 Billion. 
5. Increase the itemize tax deduction for medical expenses from 7.5% to 10% of Adjusted Gross Income, starts in 2013 and should raise an approximate $15 Billion.
6. 2.3% excise tax on medical device manufacturers and importers.  This goes into effect in 2013 and should raise an estimated $20 Billion.
7. Limit Flexible Spending Account (FSA) deferral contributions to $2500 per year.  This will be indexed for inflation, will go into effect in 2013 and will raise an estimated $13 Billion.
8. Health Insurance Companies will be required to pay a fee in 2014 towards the cost of the reform and should raise an estimated $60 Billion.

If we total all these fees, taxes and penalties we come to approximately $149 Billion Dollars!

However, there are two taxes not mentioned that together raise an additional $220 Billion Dollars alone.

Starting in 2012, for people making over $200,000 Individually or $250,000 Filing Joint, there will be an additional .09% Medicare tax on incomes over that amount.  In addition, there will be  an additional 3.8% tax on unearned income (dividends, interest, etc) if earning over those thresholds.  Therefore, if you are earning close to those amounts as a married person, you may want to consider a divorce to protect your nest egg. That will get you to $400,000 before you're hit with the taxes.  As a side-note, not so sure I'd want to be around for any of those "honey we need to get a divorce" conversations.

Now, this still leaves a fairly large gap of funding that isn't accounted for and I'm supposing that much of it will rest on the backs of our employers by way of penalties and fines for not offering health insurance or not offering comprehensive enough health care coverage.

In addition, the Bush Tax Cuts are set to expire January 1, 2011 and this also would create a huge funding source.  However, it remains to be seen if President Obama is going to extend those tax cuts.  Because, if he does, in a sense he is de-funding his own Health Reform Law.