Publications by Topic
Topic: Taxes and Health Insurance
Fix health care. But fix the deficits, too (Commentary)
Author(s):
Alan J. Auerbach , William G. Gale
CNNMoney.com, Op-Ed.
Obama and other policymakers need to pay more attention to a fundamental conflict underlying the health care debate: People want the federal government to do much more than they are willing to pay for through their taxes.
Published: 09/09/09
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Pyrrhic victory on health reform? (Commentary)
Author(s):
Leonard E. Burman
Washington Times op-ed. Leonard Burman discusses the politics of the health care reform debate.
Published: 09/01/09
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Taxing Adjusted Gross Income Instead of Taxable Income (Article/Tax Facts)
Author(s):
Jacob Goldin , Eric Toder
The House leadership has proposed to finance health care reform with a surtax on adjusted gross income (AGI) of high-income individuals, while the president's budget would increase the two top marginal tax rates on taxable income. Income taxed at statutory marginal rates is 58 percent of AGI for all taxpayers but only 46 percent of AGI for taxpayers with income over $1 million. While personal exemptions and deductions account for most of the difference between the two tax bases for the population as a whole, capital gains and qualified dividends make up most of the difference for very high income taxpayers.
Published: 08/25/09
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Tax subsidies for private health insurance: Who benefits and at what cost? (Policy Report)
Author(s):
Leonard E. Burman , Sarah Goodell , Surachai Khitatrakun
Policymakers are considering modifications to the tax treatment of employer-sponsored insurance (ESI) as a way to raise revenue to help pay for health reform and provide incentives to reduce health care costs. Understanding how current subsidies work is important to assessing health reform proposals. This brief presents essential information about the structure and distribution of existing tax subsidies for ESI and the implications for policy options.
Published: 08/18/09
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Distributional Effects of Tax Expenditures (Research Report)
Author(s):
Benjamin H. Harris , Katherine Lim , Eric Toder
The largest tax preferences for housing, health care, and retirement saving reduce federal revenues by about 3 percent of GDP. They raise after-tax income proportionally more for higher income groups than lower income groups, but raise income proportionately less for those at the very top. The net distributional effects depend on how these tax preferences are financed. If paid for with higher marginal tax rates, they benefit upper-middle income taxpayers at the expense of both lower-income and the highest-income taxpayers, but if paid for by lower per-capita spending, all high-income groups gain and all low-income groups lose.
Published: 07/21/09
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Give Up A Benefit, Gain Jobs (Commentary)
Author(s):
Leonard E. Burman
Washington Post op-ed, July 9, 2009. Employer-paid health insurance is entirely tax-free — a break that will cost the Treasury about $250 billion this year. Len Burman looks at tax-free health insurance provided by employers.
Published: 07/10/09
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The Future of Long-Term Care: What Is Its Place in the Health Reform Debate? (Research Report)
Author(s):
Howard Gleckman
More than 10 million Americans require long-term care supports and services. Yet the system for delivering and paying for this assistance is deeply flawed. While most of the frail elderly and those with disabilities prefer assistance at home, many must live in nursing homes to receive Medicaid benefits, care coordination for those with multiple chronic illnesses is poor, and the system for financing care impoverishes many middle-income families. The national health reform debate allows policymakers to reconsider long-term care as well. This paper assesses proposals to restructure the delivery and financing of long-term care services.
Published: 06/15/09
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Different Way to Pay for Health Reform (Commentary)
Author(s):
Leonard E. Burman
Washington Times op-ed, May 19, 2009. Expanding health-care access is a top priority for the Obama administration, and leaders in Congress are on board. Political leaders also agree that any health insurance expansion must not increase the deficit. So how do we pay for health care without sinking the economy? The best option would be to phase in a value-added tax (VAT) dedicated to paying for health care. Packaged with the right bells and whistles, the VAT would help revive the economy, offset the burden on low-income families, and help slow health-care costs.
Published: 05/28/09
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A Blueprint for Tax Reform and Health Reform (Research Report)
Author(s):
Leonard E. Burman
This paper outlines a plan for a VAT dedicated to paying for a new universal health insurance voucher combined with a vastly simplified and much flatter income tax. Top income tax rates could be cut to 25% or less and most taxpayers would not have to file returns. The health care voucher would offset the inherent regressivity of a VAT, since the voucher would be worth more than the VAT tax paid by most households. Moreover, with the VAT rate tied to health spending, the public would have a vested interest in reining in the growth of health care costs.
Published: 04/07/09
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Health Savings Accounts and High-Deductible Health Insurance Plans : Implications for Those with High Medical Costs, Low Incomes, and the Uninsured (Policy Briefs/Timely Analysis of Health Policy Issues)
Author(s):
Linda J. Blumberg , Lisa Clemans-Cope
Health Savings Accounts (HSAs) and high-deductible health plans are prominently featured in many discussions of health reform. The hope of supporters is that they will make individuals more prudent purchasers of medical care. However, the tax structure and incentives built into HSAs make them most attractive to the high-income and the healthy, populations already advantaged by the current system. HSA/high deductible plans shift more of the health financing burden onto those using significant amounts of care, with negative ramifications for the low-income and high-need. Nor is it clear that cost-containment, higher value shopping, or reductions in the uninsured will follow.
Published: 02/03/09
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