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The Tax Exclusion for Employer-Provided Health Insurance: Policy Issues Regarding the Repeal Debate
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The Tax Exclusion for Employer-Provided Health Insurance: Policy Issues Regarding the Repeal Debate
Huy Khiêm
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This means that services which could potentially fall within the remit of both insurance schemes tend to be shifted to the LTC insurance because this is much cheaper. Secondly, although the revenues and costs of all the German health funds are equalized to take account of their respective member structures (age, gender) (Strukturausgleich), this is not the case for the revenues and costs of the LTC funds. This leads to a high disincentive for the LTC funds to minimize their costs. Thirdly, the health insurance funds are in competition with each other as far as their contribution rates are concerned,. | Order Code RL34767 The Tax Exclusion for Employer-Provided Health Insurance Policy Issues Regarding the Repeal Debate November 21 2008 Bob Lyke Specialist in Social Legislation Domestic Social Policy Division The Tax Exclusion for Employer-Provided Health Insurance Policy Issues Regarding the Repeal Debate Summary Employer-provided health insurance is excluded from the determination of employees federal income taxes resulting in significant tax savings for many workers. Comparable exclusions apply to federal employment taxes and to state income and employment taxes. Since employment-based health insurance covers three-fifths of the population under age 65 the exclusions also result in considerable revenue loss to the government. Ending them could raise several hundred billion dollars a year depending on exactly what is repealed and how workers and employers adjust. Some see this revenue as a source for financing health care reform without explicitly raising taxes. The federal income tax exclusion the focus of this report is criticized for several reasons. Since it reduces the after-tax cost of insurance in ways that are not transparent it likely results in people with insurance obtaining more coverage than they otherwise would. Not being explicitly capped or limited it does little to restrict the generosity of the insurance or annual premium increases. These attributes contribute to what some economists argue is a welfare or efficiency loss from excess health insurance for those with coverage and also contribute to rising health care costs and spending. In addition the income tax exclusion often is criticized since it gives greater tax savings to higher income individuals and families an outcome that strikes many observers as wasteful and inequitable. These arguments about the exclusion merit careful consideration as Congress is starting to debate broad health care reform for the first time in 15 years. However the arguments involve complex issues and other points
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