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Obamacare countdown: What is slated to happen over next year?

The health-care reform law, aka Obamacare, is poised to enter a crucial 12 months that includes setting up state exchanges, levying taxes on the wealthy, and preparing for the individual mandate.

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Coverage purchased through exchanges is slated to take effect at the beginning of 2014.

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Tax hikes. Whatever the outcome of current budget negotiations, taxes on the wealthy are certain to rise in at least one area. To help pay for the Affordable Care Act's expansion of coverage, the tax on wages for Medicare Part A (hospital insurance) will rise by just under 1 percent for individuals who make more than $200,000 and for married couples who earn more than $250,000.

The increase will put this payroll tax at 2.35 percent for folks in those income levels. It's scheduled to take effect on Jan. 1, 2013.

The Affordable Care Act also mandates a new 2.3 percent tax on "medical devices," set to begin on the same date. The Internal Revenue Service hasn't yet issued final regulations setting the boundaries for what this levy will hit, however. Among the issues here is whether things often sold to consumers as well as health-care professionals, such as latex gloves, will be subject to the new tax.

Insurance mandate. The US government doesn't require you to have health insurance – yet. But that day is coming. That day is Jan. 1, 2014, to be precise, when the Affordable Care Act's individual mandate takes effect.

Starting then, adults who don't have health coverage will have to pay a fine (or tax, as the US Supreme Court ruled) of $95 per year, or as much as 1 percent of income – whichever is greater. This is scheduled to rise year by year, topping out in 2016 at $695 per adult or 2.5 percent of income.

For families, the fine goes from a maximum of $285 or 1 percent of household income to $2,085 or 2.5 percent of income, over the same period.

The fine can be waived for a limited number of reasons, including financial hardship. And it goes hand in hand with government subsidies intended to help make coverage affordable.

For instance, Obamacare calls for an expansion of Medicaid, the big federal-state health insurance program for poor and disadvantaged people. The Affordable Care Act provides a big influx of federal dollars to try to cajole states to expand Medicaid so that it includes everybody who makes less than 133 percent of the poverty level.

The US Supreme Court has said states don't have to participate in this, though, and some Republican governors have said they'll decline the expansion.

For Americans who earn a bit more, Obama­care also has provisions. Uncle Sam will provide subsidies on a sliding scale for people making up to 400 percent of the poverty level.


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