The new Health Care Reform Act affects us in different ways. The following is a summary of a special AARP Bulletin. To receive more information please consult: bulletin.aarp.org/health_care.

The part D Medicare “Doughnut Hole” shrinks. In 2010, a Medicare recipient entering the donut “gap” in coverage would receive a $250 refund toward their drug costs. In 2011, a Medicare recipient receives a 50% discount. Discounts gradually increase until the gap ends in 2020.

Starting 2011, for people of all income levels, withdrawals on a health savings account are taxed at 10 percent.

Starting 2013, married couples with a yearly income of $250,000 or more, or individuals with an income of $200,000 or more, will pay 0.9 percent more in Medicare payroll taxes and a new 3.8 percent tax on unearned income such as interest on investments, annuities and rents. The new tax excludes income from social security benefits, pensions or IRAs.

Starting 2013, one’s deductible medical expenses must exceed 10 percent, not the present 7.5 percent, of one’s income. However, for taxpayers 65 years or older the increase commences in 2016.

Starting 2014, subject to a $2,085 annual household limit, almost all adult U.S. residents who are not insured must pay a penalty of the greater of $95 or 1 percent of their income. Commencing 2016, these penalties increase to $695 or 2.5 percent of income. Types of insurance include employer and public plans, Medicaid, Medicare, Veterans Affairs or privately purchased plans. There is no seizure of property, imposition of liens on property or incarceration penalty for non-payment.

For family plans, children can be covered until age 26.

Businesses with 25 full-time employees or fewer with an average annual salary of $50,000 or less will receive a tax credit up to 35 percent of premiums paid on employee health coverage.

Starting 2014, employees who do not have employer-provided insurance may purchase health insurance through state-run exchanges. One may be able to compare health plans on these exchanges on-line.

For many health care options people with low or moderate income may qualify for tax credits and subsidies.