Among the promises of the health reform law -- now in the hands of the Supreme Court -- is affordable insurance for millions of low- and middle-income Americans.
But delivering on that promise won't be free.
The federal government is set to spend more than $1 trillion over the next decade to subsidize coverage and to expand eligibility for Medicaid.
And to pay for it, the law imposes a slew of cuts in federal health care spending, as well as a number of taxes, fees and penalties.
Those taxes will be paid by health sector companies and hospitals; employers and consumers.
Individuals who will help foot the tab -- directly or indirectly -- include very high-income households, those with very generous health benefits at work, those who opt to remain uninsured and those who love a good indoor tan.
Medicare surtax: Starting in 2013, many individuals making more than $200,000 a year ($250,000 if married) will start paying more into Medicare.
The health reform law changes the Medicare tax in two ways: It adds a surtax on wage income above a certain level, and it creates a new Medicare tax on investment income.
Some high-income households will only be subject to one of those changes, and some will be subject to both.
Starting next year, high-income individuals will pay another 0.9 percentage points on their earned income over $200,000 ($250,000 if married). That's on top of the 1.45 percent they currently pay on all of their wages.