Here's Who Pays for Health Care Reform Universal coverage isn't free; CNN breaks down the costs By Kevin Spak, Newser User Posted Jun 26, 2012 3:48 PM CDT 180 comments Comments Someone's paying for the affordable care act. (Shutterstock) (Newser) – Assuming the Supreme Court doesn't strike it down, the Affordable Care Act will extend health care to millions of Americans—which isn't a cheap proposition. CNN breaks down who would wind up paying for the law, and how: The wealthy: Starting next year there's a Medicare surtax on incomes above $200,000 a year, or $250,000 for a married couple. It also adds a Medicare tax on capital gains and dividends. People with awesome insurance: If your employer-sponsored plan costs more than $10,200 a year, or $27,500 for family coverage, it'll be subject to an excise tax in 2018. HSA users: The amount of money they'll be able to put into a flexible spending account tax-free will be capped at $2,500 next year. There will also be a 20% penalty if participants use those funds for non-health spending. The uninsured: Anyone choosing not to buy insurance will have to pay a penalty under the individual mandate. That will start in 2014 with a cap at $285 per family, or 1% of income, whichever is higher, and eventually rising to $2,085 per family, or 2.5%, in 2016. For single adults, it starts at $95 and rises to $625. Those with very low incomes are among the exceptions. The really sick: Right now, you can deduct medical costs that exceed 7.5% of your income. That's going up to 10%, though the jump will be waived for seniors until 2016. The Jersey Shore cast: And anyone else using tanning salons, which are subject to a new 10% excise tax.