It's a carbon tax. You only pay it as long as most of the food mass that you consume is excreted through your nostrils.
However, the Medicare tax itself was debated as a tax, enacted as a tax, signed into law as a tax, and imposed as a tax. Nobody doubted its "taxiness" or the authority that Congress, with taxing authority, used in imposing the tax.
Of course, it's supposed to be a program paid for entirely by a dedicated tax and, since it's health-care, you'd assume that it was somehow included in the ACA. But in practice a huge chunk of it is paid for by general revenues since the the dedicated tax doesn't cover the bills, and Medicare may have been talked about widely in passing the ACA but, in point of fact, the extra hundreds of billions of dollars Medicare funding is still a stand-alone expense unaffiliated with the ACA.
As with many other things, once Medicare became largely a general-fund program it was part of the deficit problem and deficit solution. So as part of a budget deal a decade ago, mandatory cuts became necessary to the general-fund portion under certain conditions--in exchange for promising to abide by mandatory, automatic cuts, Congressional factions agreed to certain spending levels for other programs. However no Congress, (R) or (D), has ever dared to actually let the automatic cuts happen. It's a classic case of "spend now, save later ... but although it's 'later' now it's really just 'now' all over again and we said we'd save only when it's later."
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