The Affordable Care Act (ACA) imposes several new fees and taxes on health plans and issuers, including the Transitional Reinsurance Program Fee, PCORI Fee, Health Insurance Providers Fee, and the “Cadillac Tax.” The ACA also imposes an Additional Medicare payroll tax on wages above a certain threshold. These fees and taxes serve different purposes that range from funding the subsidies that are available through the public Exchanges to funding research into more effective methods for delivering health care.