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    Bad framing on the excise tax

    Mon, 01/11/2010 - 10:03 EDT - Ezra Klein - Washington Post
    • Comments
    • Health Reform

    A lot of the arguments over the excise tax are getting caught in a bad, and even slightly dishonest, sales job from its supporters. Sen. John Kerry's blog post defending the policy, for instance, isn't playing it straight. Saying it won't tax employees is a distinction without a difference: It will tax insurers, which will add the tax into the cost of their plans, and employers will either choose different plans or pass the cost on to employees. Similarly, saying it will affect only "3% of premiums in 2013" is designed to obscure the fact that it will hit a lot more policies in 2020. But this is one of those cases when bad arguments mask a good policy, rather than the other way around.

    Health benefits should be taxed. There's no reason the system should make a dollar in employer-provided health insurance worth more than a dollar in wages. That's a straight incentive for employers to spend more and more on health insurance, which is contrary to the needs of the country right now. The excise tax begins to expose a small portion of employer-provided health-care costs to taxes. Meanwhile, someone who doesn't get employer-provided health care and buys their own insurance is getting taxed on every dollar they spend on health care.

    No one defends this system in principle. They only defend it in practice. The excise tax has its opponents, but none of them say we should make food, or broadband Internet, tax free as long as it is provided by employers -- even though those things are also important! You don't even hear them demanding that the bill make non-employer-provided health care tax free. No one, in other words, is interested in expanding this system to other sectors, or even to the rest of the health-care sector. But given that this subsidy is worth about $250 billion a year, it's got a lot of defenders.

    As a final note, the excise tax is a substitute for simply capping the employer tax exclusion. The swap came about because the politics of the excise tax are superficially better: Rather than taxing "workers" or "businesses," you're taxing "insurers." But insurers pass the cost along, of course. And the excise tax is more regressive than capping the exclusion. If you cap the exclusion, people get taxed at their normal marginal tax rate, which is virtually nothing for low-income workers. The excise tax, by contrast, is a flat surtax of 40 percent, no matter what your income. in this case, making the tax sound more populist also made it substantially more regressive.


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    Related

    • Explaining the excise tax

      If a new tax is passed and no one actually pays it, can it fund health-care reform? It sounds like a zen koan for public policy students. But the Senate Finance Committee is banking on it. The excise tax on employer-provided, high-value health insurance is something of an odd bird: It's a new tax that raises money even, and perhaps especially, if people manage to avoid paying it.

    • What Do the Insurers Want?

      The "analysis" the insurance industry commissioned should not be treated as a policy document. It's a political document. In it, the insurers assail policies they don't like (though under the guise of concerning themselves with consumer premiums) and pump up policies they do like. There's no real "prescriptions" section to the paper, but it's easy enough to discern what the insurers do, and don't, want.

    • Attacking the excise tax -- and cost control

      Bob Herbert's column today isn't so much a good argument against the excise tax as it is an example of why cost control will be virtually impossible, and thus national bankruptcy -- a real decrease in wages -- is a near-certainty.

    • Explaining the excise tax: part 2

      Sigh. On the same day I publish my long explanation of the excise tax, the Center for Budget and Policy Priorities publishes their even longer explanation of the excise tax. You just can't win against these wonks.

    • Why I support the excise tax

      R.J. Eskow wants me to write a lot more about the excise tax, and in particular about the claims of its opponents, and wonders why I haven't been. It's probably useful to answer the meta-question as well as the policy question, if only in terms of setting out the premises of this blog: I am not comprehensive. I can't pick every fight, and don't want to try.

    • Health Reform’s Union Problem

      Tim Fernholz observes that the Senate version of health reform has a big problem with Big Labor:

    • The excise tax and its critics

      If you're looking for the skeptic's case against the excise tax, Alec MacGillis's article is pretty comprehensive. I certainly see how people find it convincing. I'm just not among them.

    • Health Care Excise Tax Blogging

      The idea of taxing health insurance benefits entails a lot of complexity, but in a general sense it comes down to a pretty simple question. Do you think that John, who earns $80,000 a year and gets an insurance plan worth $8,000 should pay more taxes than Jim who earns $70,000 a year and gets an insurance plan worth $18,000? After all, John and Jim are both getting $88,000 worth of compensation so it seems like they should pay the same in taxes. But under the current system, Jim pays substantially less.

    • HCAN Vs. the Excise Tax

    • Health Reform for Beginners: The Employer Tax Exclusion

      This is why people are bored by health care policy. This, right here. The fact that the central concept in health care reform relies on the differential tax treatment of health care benefits when provided by your employer. Even italicizing that sentence doesn't make it more interesting. But the importance of the employer tax exclusion is simple enough: The hinge question in health care reform is "where do you get the money?" And the main -- and most controversial -- pot of money in health care reform comes from the employer tax exclusion.

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