by Russ Wiles - Jul. 28, 2012 05:48 PM The Republic | azcentral.com

Now that the Supreme Court has upheld the Affordable Care Act, it's time to start picking through the details. Several key tax rules are scheduled to change in 2013, especially for higher-income individuals.

Republicans are still trying to overturn the law, and that could happen based on what transpires in the November election. But if nothing changes, here's what to expect in terms of the health-related tax impact, with focus on items that apply to individuals rather than businesses:

New Medicare tax. Higher payroll withholding is on the horizon with the introduction of a 0.9 percent tax starting in 2013. It will hit people with earned income exceeding $200,000 for singles and $250,000 for married couples filing jointly. That's in addition to the current Medicaid tax of 1.45 percent.

New investment-income tax. The legislation also imposes a 3.8 percent levy on interest, dividends, some rents and other unearned income for people above those $200,000/$250,000 income levels. This levy, also designed to support Medicare, starts in 2013.

"This 3.8 percent tax would be on top of any increase in the dividends/capital-gains/ordinary-income rates that (take effect) ... upon expiration of the Bush-era tax cuts at the end of 2012," according to tax-researcher CCH.

Top rates rising. That 3.8 percent Medicare addition plus scheduled regular-tax increases mean the top effective rate for high-income earners could go from the current 35 percent to 43.4 percent in 2013, said Jason Miller, manager of financial planning at Harris Private Bank in Scottsdale. The capital-gains rate could go from a top 15 percent this year to 23.8 percent next year.

Harvesting or prematurely locking in capital gains, normally an unwise strategy, could make sense, Miller added. So could accelerating income into 2012 rather than deferring it, if possible. In one strategy cited by Mark Luscombe, principal analyst at CCH in suburban Chicago, you might opt to convert a regular IRA into a Roth, paying the applicable taxes at this year's lower rates and thereby securing tax-free withdrawals in future years.

Incidentally, selling a home for a large capital gain after this year could be costly, since the gain could increase net investment income and boost adjusted gross income above the $200,000/$250,000 threshold amounts. However, most people won't face the tax on a home sale, as individuals still will be able to shelter up to $250,000 and couples $500,000 in gains on the sale of a primary residence, said Luscombe.

In other words, the new 3.8 percent tax applies to housing capital gains above the $250,000/$500,000 limits only if your income exceeds the thresholds.

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Health-care act to have tax impact