The Affordable Care Act has survived a U.S. Supreme Court challenge and a tight presidential election. What's next?


Individuals earning above $200,000 and married couples making more than $250,000 will pay an extra 0.9 percent Medicare payroll tax on income above those thresholds. They'll also face a 3.8 percent tax on unearned income, such as dividends and interest, but not on the sale of a principal residence.

Medical device manufacturers and importers must pay a 2.3 percent federal sales tax, which Minnesota's congressional delegation is trying to repeal.


Insurance requirements kick in. For those who choose not to buy insurance, the tax penalty is $95 for individuals and $285 for families, or 1 percent of income, whichever is greater. Businesses with more than 50 workers must offer a plan that covers at least 60 percent of medical care and costs less than 9.5 percent of an employees' income. The penalty is $2,000 per full-time employee, exempting the first 30 workers.

Exchanges go online to sell insurance to individuals, families and small businesses. The federal government will offer subsidies and tax credits to some consumers and small businesses to help make coverage more affordable.

Adults with pre-existing conditions can no longer be denied insurance coverage (children have been protected since September 2010). Additionally, insurers can't cancel your plan once you get sick.

States that choose to expand Medicaid coverage for low-income citizens will get reimbursed 90 to 100 percent by the federal government. Benefits would cover legal citizens earning less than $15,302 or to a family of four earning $31,155.


Penalties for individuals who don't buy insurance coverage rise to $695 for individuals and $2,085 for families, or 2.5 percent of income.


Employers will pay a 40 percent excise tax on coverage that hits the most generous or "Cadillac" plans.


Coverage gap for prescription drugs for seniors, known as the "doughnut hole," will be closed and seniors will be responsible for 25 percent of medicine costs.