Although Obamacare was signed into law in 2010, very few of its rules and regulations have gone into law. This was by design: the Obama Administration wanted to give executive departments time to set definitions, insurance companies time to adjust to the new reality, and didn’t want Americans shocked – and perhaps outraged – by all the ways their lives would be affected. Including by taxes.

In 2013, though, some of the new tax hikes will start to be phased in. As Sally Pipes of the Pacific Research Institute writes, there are five major tax changes that will affect Americans in the coming year:

On January 1, 2013, a 2.3-percent excise tax on the total revenues of medical-device companies — regardless of whether they turn a profit or suffer a loss — will take effect. The tax will hit everything they sell, from x-ray machines and pacemakers to surgical tools and artificial hips. The levy could extract as much as $29 billion over the next 10 years.