(MONEY Magazine) – With the exception of raising the 24 cents-a-pack cigarette tax, Congress has so far avoided proposing in-your-face tax hikes to pay for health reform. But don't be fooled. Lawmakers are lining up less obvious ways to get you to help finance health care overhaul. The three changes outlined here, which would strike at MONEY readers, all figure to become law -- if not this year, then soon after. Says Lawrence Goldberg, a health-care consulting director for the accounting firm Deloitte & Touche: "Enacting real health reform will span a decade, with taxes and spending cuts required every step of the way." Here's what you can expect and what to do now to prepare: -- Employees. Health-care flexible spending accounts, which help take the bite out of fat medical bills, are as good as dead. Currently, more than half of all large companies let employees set aside pretax dollars in FSAs --generally up to $3,000 a year -- to pay for unreimbursed medical costs, including deductibles, co-payments and specific items, such as glasses. Congress would ax that popular benefit. Why? Lawmakers have convinced themselves that employees would shop for medical care more carefully if the expenses weren't shielded from taxes. What to do. Make the most of your FSA while it lasts. If FSAs aren't gutted this year and your firm offers one, you'll be asked to sign up sometime around November for 1995. But remember: FSAs operate on a use-it-or-lose-it basis. If you elect to have, say, $1,000 put aside pretax for health costs and wind up not spending that much, you forfeit the money. -- The self-employed. Despite President Clinton's campaign proposal to let all self-employed people deduct 100% of their health insurance premiums, Uncle Sam can't afford such a lush tax break any time soon. Instead, the reform law would more likely call for a deduction --retroactive to Jan. 1, 1994 -- equal to just 25% of premiums through at least 1995, rising thereafter to 80% or 100%. (The same 25% write-off expired Dec. 31, 1993.) As '96 nears, however, Congress may well delay increasing the deduction, especially if health-care costs have risen more than projected. What to do. For now, project your costs for health insurance premiums as if the 25% deduction is all you'll ever get. Despite the measly write-off, don't let your health insurance lapse. -- Retirees. Key lawmakers in both parties think that starting in 1996, upper- income retirees -- generally couples making at least $115,000 and singles earning over $90,000 -- should pay 75% of the $164.40 monthly Medicare Part B premium for doctors' bills, or $123.30. Today they pay 25%, or $41.10. What to do. Build a suitable cushion into your retirement budget now. "People don't think retirement planning includes health care," says George E.L. Barbee, executive director of client services at the accounting firm Price Waterhouse. "They believe the government will take care of them. We tell our clients: 'Don't be naive; create a kitty for health care.'" --