The Affordable Care Act will cost more than $1 trillion over the next decade. The measure will be paid for in part by some charges you might not expect and will require you to make some choices.


  • When the act was passed, the government started offering five-year grants in which small businesses that set up wellness programs can get incentives worth up to 30% of premiums.


  • Employers must state the value of their insurance coverage on their employees’ W-2 forms.
  • Companies’ flexible spending plans cannot exceed $2,500.
  • Workers earning $200,000 or more annually will have more money withheld from their paychecks to cover Medicare.
  • High-income earners will pay 0.9% more in federal taxes and 3.8% more on investment income.
  • Companies with fewer than 25 employees will be eligible for a tax credit of 35% in 2013 and 50% starting in 2014 if they insure workers and pay for at least half of their premiums.


  • Limits on deductibles and out-of pocket expenses take full effect.
  • An employer cannot wait more than 90 days before adding a new worker to its health care plan.
  • Companies must decide to provide coverage or make it possible for their workers to get insurance through exchanges.
  • Companies with 50 or more employees must offer insurance, move workers into exchanges, or pay a penalty of $2,000 per year per employee starting with worker No. 31.


  • Plans valued at more than $10,200 per individual and $27,500 per family will be hit with an excise tax.