U.S. employers and consumers will bear the brunt of more than $20 billion in fees to be assessed in 2014 under the Affordable Care Act. Health insurers are passing the mandatory fees on to many people, including those who buy coverage directly from insurers or who get health benefits through their jobs. In some cases, Medicare Advantage plans and Ohio's Medicaid managed-care plans also will have to pay. "These are administrative expenses that the Affordable Care Act put in place," said Jeff Williamson, the director of health-care reform for Medical Mutual of Ohio. "They're a cost of doing business as an insurance company."