Federal taxes and fees

• The Comparative Effectiveness Fee. This annual fee funds the Patient-Centered Outcomes Research Institute. The institute compares how well different medical treatments work.
• The Marketplace Fee. The Affordable Care Act created a new way to shop online for health insurance. It’s called the Health Insurance Marketplace. This fee pays to support the Marketplace and has made it self-sustaining.
  
• The Risk Adjustment Fee. This fee funds the risk adjustment program. The program helps to keep the cost of health insurance more stable.
  

State taxes

• The Insurance Provider Assessment. The Insurance Provider Assessment requirements were effective on Oct. 1, 2018. The assessment helps fund the state Medicaid program.
• The State Insurance Premium Tax. A tax on Michigan-based health insurance premiums.