he president's proposal, like the Senate and House bills, also offers a series of health care delivery system reforms that hold the promise of reducing health care costs over time, and to reducing waste in Medicare spending. But many of the changes the proposal calls for aren't free. Obama proposes to pay for the additional burden on the federal coffers in several ways. Among those that would have a direct bearing on individuals and businesses, he would: Tax high-cost medical plans: Obama would impose an excise tax on insurers offering high-cost health insurance policies. The idea behind the tax is to persuade workers and employers to choose lower cost plans. While technically it's a tax on insurers, insurers are expected to pass along those costs to their policyholders. 0:00 /3:47Address obesity first Once employers start spending less money on health care they will use the money saved to pay workers higher wages, or so the economic theory goes. The workers will then owe income tax on those higher wages, providing revenue to help pay for health reform.