The Truth on Health Care Reform and Taxes

As we move into the final stage of the historic push for health reform, opponents of reform are testing the age old adage that if you only say something enough times you can somehow make it true.  Yesterday, we heard a new version of the old, tired refrain that the health reform bills in Congress would raise taxes on the middle class.

So let's set the record straight:

  • First, the health insurance reform bill being considered in the Senate does not raise taxes on families making less than $250,000 – in fact it is a substantial net tax cut for American families. The bill being considered represents a substantial net tax cut for middle income families. According to the independent Joint Committee on Taxation, the bill will provide nearly $450 billion in individual income tax cuts over the next 10 years.
  • Second, the excise tax levied on insurance companies for high-premium plans, the so-called "Cadillac tax," will affect only a small portion of the very highest cost health plans – a total of 3% of premiums in 2013. The vast majority of health plans fall below the thresholds set in the Senate plan and would be completely unaffected by the provision. And those that are above the threshold would only face an excise tax on the generally small portion of the plan that exceeds the threshold. As a result, based on analyses by the Joint Committee on Taxation, only about 3% of premiums will be affected by this provision in 2013. In addition, the Senate plan provides special protections to plans held by workers in high-risk professions – like police and firefighters – as well as by those over 55.
  • Third, for the small sub-set of plans that are affected, the primary impact of this provision will be to increase workers' wages. Getting a pay raise is not what most people would call a tax increase. Economists agree by taxing the highest cost plans this provision will lead insurance companies to be more efficient and provide quality care to consumers at lower prices (see this endorsement in a letter from a group of prominent economists – including three Nobel laureates and previous members of both Democratic and Republican administrations and this analysis by CBO 2009). Even a report commissioned by the insurance industry's trade association acknowledged that: "[w]e expect employers to respond to the tax by restructuring their benefits to avoid it." [PWC, 2009].  As a result, employers will be in a position to increase workers' take home pay.
  • Finally, supporters of the status quo are supporters of continuing the hidden tax of $1,000 that the millions of Americans who get insurance through their job or buy it on their own are already paying each year to cover the costs of caring for those without insurance. Even if you believe that some of the tax on insurance companies is passed along, it would be more than outweighed by the benefits middle-class families would get from not only hundreds of billions of dollars in health care tax credits but from reducing the hidden tax they currently pay for the uninsured. Supporters of the status quo would not only deny middle-class families the tax cuts proposed in the Senate legislation, they would also continue this unfair hidden tax.

Jason Furman is Deputy Director of the National Economic Council

Related Topics: Health Care, Taxes
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