Health care law's tax hikes are coming: Who pays?

The lowdown: New taxes and fees target businesses expected to profit as more Americans get insurance. The companies will pass along these expenses as higher prices when they can. Companies that make or import brand-name prescription drugs paid a total of $2.5 billion in 2011, the first year for their fees. Insurance companies will share in paying an annual fee that starts at $8 billion for the first year.

When: Began last year for drug companies; starts in 2013 for device makers, 2014 for insurance companies.

THRIFTY SAVERS

Who pays: People who set aside tax-free savings to pay for health care.

How much: About $33 billion over 10 years

The lowdown: The law limits annual contributions to medical Flexible Spending Accounts to $2,500; there was no government limit before. Many employers had allowed $5,000 in the accounts, and some even more. But the average contribution was only $1,400 per year, so relatively few workers will be affected. Four in 10 employees have jobs that give them the chance to sign up for these accounts.

When: Contribution limit begins in 2013.

TAXPAYERS WHO TAKE WRITE-OFFS

Who pays: People with big medical or dental bills who itemize deductions.

How much: Almost $19 billion over 10 years. Currently, taxpayers have to spend more than 7.5 percent of their adjusted gross income on medical care to qualify for a deduction. The threshold will rise to 10 percent. So a household with income of $50,000 would have to spend $5,000 on health care before deducting amounts above that.

The lowdown: Most Americans don't have enough out-of-pocket expenses, those not paid by insurance, to meet even the lower threshold.

When: 2013 (delayed until 2017 for taxpayers age 65 or over)