Additional Info on Health Reform

Kurt Bouwhuis, Mackinac Center Intern

Here is some additional information to consider when determining whether or not the health care reform is a net benefit for Americans.  I will only highlight the major points.  To see a more thorough list, check out the information provided by the Tax Foundation (the source of information provided below):

The major provisions, as defined as those projected to raise or lose more than $10 billion within the ten year budget window, are denoted in red.

Retroactive provisions

Exclusion for assistance provided to participants in State student loan repayment programs for certain health professionals (retroactive to January 1, 2009)

Small Business Tax Credit for certain small businesses (those meeting certain criteria) providing health insurance to employees (retroactive to January 1, 2010). In 2013, restricted only to insurance purchased through an exchange and only available for two conseutive years

Exclusion of unprocessed fuels from the cellulosic biofuel producer credit (retroactive to January 1, 2010)

Provisions going into effect on the date bill is signed into law

Provide income exclusion for specified Indian tribe health benefits

Tax Exemption for Certain Member-Run Health Insurance Issuers

Rules pertaining to how the IRS is involved in income-verification and individual status for the purposes of participation in the exchanges and subsidies received

Other provisions going into effect before the end of 2010

July 1, 2010: Impose 10% excise tax on indoor tanning services

Provisions going into effect in 2011

Employer W-2 reporting of value of health benefits

Increase in additional tax on distributions from HSAs and Archer MSAs not used for qualified medical expenses to 20%

Impose annual fee on manufacturers and importers of branded drugs ($2.5 billion for 2011, $2.8 billion per year for 2012 and 2013, $3.0 billion per year for 2014 through 2016, $4.0 billion for 2017, $4.1 billion for 2018, and $2.8 billion for 2019 and thereafter)

Provisions going into effect in 2012

Require information reporting on payments to corporations

Provisions going into effect in 2013

Limit health flexible spending arrangements in cafeteria plans to $2,500; indexed to CPI-U after 2013

Impose 2.3% excise tax on manufacturers and importers of certain medical devices

Raise 7.5% AGI floor on medical expenses deduction to 10%; AGI floor for individuals age 65 and older (and their spouses) remains at 7.5% through 2016

Broaden Medicare Hospital Insurance Tax Base for High-Income Taxpayers – additional HI tax of 0.9% on earned income in excess of $200,000/$250,000 (unindexed), and Unearned Income Medicare Contribution on 3.8% on investment income for taxpayers with AGI in excess of $200,000/$250,000 (unindexed)

Impose Fee on Insured and Self-Insured Health Plans; Patient-Centered Outcomes Research Trust Fund (expires after 2019)

Provisions going into effect in 2014

Increase by 15.75 percentage points the required corporate estimated tax payments factor for corporations with assets of at least $1 billion for payments due in July, August, and September 2014

Impose annual fee on health insurance providers ($8 billion in 2014, $11.3 billion in 2015 and 2016, $13.9 billion in 2017, $14.3 billion in 2018, and indexed to medical cost growth thereafter); based upon firm’s market share starting in 2013

Excise Tax (i.e., penalty) on Individuals Without Essential Health Benefits Coverage

Excise Tax (i.e., penalty) on Employers Not Providing Health Insurance Coverage to Employees (Shared Responsibility for Employers)

Refundable Tax Credit Providing Premium Assistance for Coverage Under a Qualified Health Plan

Requirement that employers report health insurance coverage

Provisions going into effect in 2018

40% excise tax on health coverage in excess of $10,200/$27,500 (subject to adjustment for unexpected increase in medical costs prior to effective date) and increased thresholds of $1,650/$3,450 for over age 55 retirees or certain high-risk professions, both indexed for inflation by CPI-U plus 1%; adjustment based on age and gender profile of employees; vision and dental excluded from excise tax; levied at insurer level; employer aggregates and issues information return for insurers indicating amount subject to the excise tax; nondeductible


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