Does the ACA increase the Medicare payroll tax on earnings for upper income Americans?

Asked by: Dr. Darwin Jerde  |  Last update: January 18, 2026
Score: 4.1/5 (19 votes)

An additional 0.9 percent Medicare tax on earnings and a 3.8 percent tax on net investment income (NII) for individuals with incomes exceeding $200,000 and couples with incomes exceeding $250,000. The additional Medicare tax is projected to raise $17 billion and the NII tax is projected to raise $46 billion in 2023.

Who pays the 3.8% Medicare surtax?

The Medicare Tax Only Affects High-Income Taxpayers

If you're single, you must pay the tax only if your adjusted gross income (AGI) is over $200,000. Married taxpayers filing jointly must have an AGI over $250,000 to be subject to the tax.

Does the Affordable Care Act increase taxes?

Additional taxes at higher incomes

The Affordable Care Act also imposes two new taxes in addition to new reductions to exemptions and itemized deductions on people with higher income. The first new tax is the Net Investment Income Tax, which was added to the bill to help offset the costs of the law's major provisions.

Why did my Medicare tax go up on my paycheck?

Under the Affordable Care Act, taxpayers who earn above a set income level (depending on filing status) pay 0.9% more into Medicare on top of the regular contribution.

How do I avoid paying 3.8% Medicare surtax?

Look for ways to minimize your AGI. The lower your AGI (the number at the bottom of the TAX-FORM 1040) the lower the amount of your income will be subject to the 3.8% surtax. Need another reason to contribute to your retirement plan? Making contributions to your 401k, 403b or pension will lower your AGI.

Average Salary in the U.S. - 2024 Update - How does YOUR income compare?

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What is the extra tax on high income earners?

You May Be Subject to Two Additional Taxes on Your Income

Certain high-income taxpayers face two additional taxes. The first is called the Net Investment Income Tax (NIIT). This charges an additional 3.8% tax on investment income (e.g., interest, dividends, annuities, royalties, and rents) for high-income earners.

Do high income earners pay more for Medicare?

If we determine you're a higher-income beneficiary, you'll pay a larger percentage of the total cost of Part B based on the income you normally report to the Internal Revenue Service (IRS). You'll pay monthly Part B premiums equal to 35%, 50%, 65%, 80%, or 85% of the total cost, depending on what you report to the IRS.

How much federal income tax do I pay on $200,000?

22 percent on taxable income between $47,150 and $100,525; plus. 24 percent on the amount over $100,525 up to $191,950; plus. 32 percent on the amount over $191,950 up to $200,000.

Is there a salary cap for Medicare taxes?

There's no wage-based limit for Medicare tax. All covered wages are subject to Medicare tax. If you receive wages over $200,000 a year, your employer must withhold a . 9% additional Medicare tax.

What is a disadvantage of the Affordable Care Act?

Impact on Individual Insurance

It was also known that consumers would face a very different health insurance world under the ACA, with some people seeing their premiums go down and some seeing them go up, and the majority of Americans seeing higher deductibles, higher copays, and a smaller pool of providers.

What is the Medicare tax on the ACA?

An additional 0.9 percent Medicare tax on earnings and a 3.8 percent tax on net investment income (NII) for individuals with incomes exceeding $200,000 and couples with incomes exceeding $250,000. The additional Medicare tax is projected to raise $17 billion and the NII tax is projected to raise $46 billion in 2023.

How can I avoid paying back my premium tax credit?

Report any changes in your income during the year to the Marketplace, so your credit can be adjusted and you can avoid any significant repayments at the end of the year.

What is the Medicare surcharge for high income?

A 0.9% Additional Medicare tax applies to Medicare wages, self-employment income, and railroad retirement (RRTA) compensation that exceed the following threshold amounts based on filing status: $250,000 for married filing jointly; $125,000 for married filing separately; and. $200,000 for all other taxpayers.

At what age do you stop paying Medicare taxes?

You are eligible for premium-free Medicare Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.

How to avoid niit?

Invest in Roth retirement accounts: Qualified distributions from Roth accounts are excluded from your MAGI in retirement, helping you avoid the NIIT later in life. Invest in municipal bonds: Investing more funds in municipal bonds can be helpful because the earnings won't increase your MAGI.

At what age is social security no longer taxed?

Social Security income can be taxable no matter how old you are. It all depends on whether your total combined income exceeds a certain level set for your filing status. You may have heard that Social Security income is not taxed after age 70; this is false.

Is 200k a year rich?

Yes, it is. In fact, that level of income significantly surpasses what a typical American worker earns in a year. But it's worth noting that your local cost of living and financial obligations can impact how far the money goes.

Do rich people pay more for Medicare?

Wealthy enrollees pay more into Medicare than poorer people do (in the form of general federal tax revenues and payroll taxes). However, they reap greater benefits over their lifetimes because they live longer and use more medical services.

How do I fight a high income Medicare surcharge?

So how do you file the life changing event appeal? You will use Form SSA-44 (Medicare Income Related Monthly Adjustment Amount – Life Changing Event). Complete the required information on the form and submit to a local Social Security office.

How does the Medicare tax rate change for high earners?

The Medicare Contribution Tax

Wages or net earnings greater than $200,000 (single), $250,000 (married), or $125,000 (married but filing separately) will now be taxed at an overall rate of 3.8 percent. The 0.9 percent rate increase applies only to the employee's (or self-employed taxpayer's) share of the Medicare tax.

How do I pay less taxes on high-income?

15 Ways to Reduce Taxes for High-Income Earners
  1. Maximize Retirement Contributions. ...
  2. Contribute to a Health Savings Account. ...
  3. Use Deferred Compensation Plan. ...
  4. Maximize Individual Deductions. ...
  5. Create Large Charitable Contributions. ...
  6. Leverage Business Write-offs. ...
  7. Create Real Estate “Paper” Losses. ...
  8. Borrow Against Your Investments.

What is the 3.8 Obamacare tax?

The 3.8% ACA tax on net investment income applies to unincorporated taxpayers (basically individuals, estates, and certain trusts) who have a modified adjusted gross income (MAGI) above these annual income levels: $250,000 in the case of married taxpayers filing a joint return or a surviving spouse.

What is the Medicare tax rate for high-income employees in 2024?

Employers are required to withhold the additional Medicare tax at a 0.9 percent rate on wages and other compensation paid to an employee in excess of $200,000 in a calendar year. There is no employer match for the additional Medicare tax.