In addition to the surtax, business groups oppose a public insurance option and an employer "play-or-pay" mandate for all but the smallest employers, under which businesses that don't provide health insurance for their workers would pay a penalty to the government.
Such taxpayers are generally exempted from the 3.8% Medicare Surtax unless their business either (a) is a passive activity with respect to such taxpayer or (b) is a trade or business involved in trading in financial instruments or commodities.
Taxpayers are also subject to the 3.8% Medicare Surtax on gross income derived during the ordinary course of a trade or business (a) of trading in financial instruments or commodities, or (b) is considered a passive activity with respect to the taxpayer.