Set up the new taxes

Months 0–18 · Treasury, IRS, SSADiscuss this step

Every existing law, program, institution, or practice this step changes: what it is today, what happens to it, when, and what that costs or trades off.

What	Today	Change	Trade-off
Employer mandate (IRC §4980H) replacedYear 4 Federal tax code	Large employers must offer coverage or pay a penalty.	Repealed; replaced by the universal employer health payroll tax.	No more 30-hour cliffs that push employers to cap part-timers' hours.
Medical expense deduction (IRC §213) and self-employed health insurance deduction (§162(l)) amendedBy wave Federal tax code	Itemized deduction above 7.5% of AGI; self-employed deduct premiums.	Self-employed premium deduction ends; medical deduction kept for non-covered costs (e.g., nursing-home room and board).	Small revenue gain; keeps relief for catastrophic non-covered costs.
Employer health payroll tax (new) newPhased Years 1–4 Federal tax code	—	7.5% of payroll above a $250,000 per-employer exemption; self-employed above $50,000 of net earnings. Employer health payroll tax (new) $0.0B → $742.8B Federal employer health payroll tax (new) $0.0B → $30.0B State & local employer health payroll tax (new) $0.0B → $100.5B	Universal and predictable; new cost for employers that never offered coverage.
Household income-based health premium (new) newPhased Years 1–4 Federal tax code	—	4% of AGI above $16k–$32k+ size-adjusted exemption, through withholding.	Proportional to income rather than flat per person; visible tax.
Top-end surtax, capital-gains change, financial transactions tax (new) newYear 1 Federal tax code	Top rate 37%; long-term capital gains 20% (+3.8% NIIT).	7% surtax above $1M AGI; gains and dividends taxed as ordinary income above $1M; 0.1% FTT.	Progressive but volatile and avoidance-prone revenue.
IRS health-coverage reporting (Forms 1095-A/B/C) replacedYear 4 Federal tax code	Insurers and employers report coverage for ACA subsidies and the employer mandate.	Ends; replaced by payroll-tax and household-premium reporting.	Less paperwork; new household-premium withholding must be administered.