Large group plans would have to spend at least 85 percent . -- Increases the Medicare payroll tax and expands it to dividend , interest and other unearned income for singles earning more than $ 200,000 and joint filers making more than $ 250,000 . -- Provides subsidies for families earning up to 400 percent of the poverty level -- or , under current guidelines , about $ 88,000 a year -- to purchase health insurance . -- Requires most employers to provide coverage or face penalties . -- Requires most people to obtain coverage or face penalties . -- Imposes a 40 percent excise tax on high-end insurance policies . -- Expands health insurance coverage to 32 million people .