The American public is deeply divided over whether to raise taxes to pay for health reform. A fascinating Kaiser Family Foundation review of recent survey data finds that in five polls taken over the past four months, about half of those questioned said they’d be willing to pay higher taxes as the price of reform.

However, the amount of tax they are willing to pay appears to be low, they’d much prefer someone else pay, and they don’t like the idea of taxing employer-sponsored insurance one bit. Most striking, a dispiriting 60 percent think the system can be fixed without spending any more money at all—an outcome that no health economist I know thinks is remotely possible.

As the Kaiser paper notes, much depends on how the question is presented. For instance, 57 percent said they’d pay higher taxes when CBS and the New York Times asked about a plan where “all Americans have health insurance they can’t lose, no matter what” Unfortunately no plan being seriously considered in Washington would cover all of the uninsured. When Kaiser asked if people would be willing to pay more “in order to increase the number of Americans who have health insurance”—a much more realistic description—only 41 percent said they would.

When it comes to the kind of tax increase people prefer, taxing employer-sponsored plans gets a collective thumbs-down, whether the question focuses on the most generous plans or all coverage. No matter how the question is asked, no more than 40 percent of respondents favor such a tax hike, and in most formulations, two-thirds oppose the idea.

So what kind of tax increase does the public like? As President Obama has concluded, two-thirds are happy to raise income taxes on those making $250,000 or more. This proves once again that Russell Long’s old doggerel: “Don’t tax me, don’t tax thee, tax that fella behind the tree” remains as true as ever. Respondents also support raising taxes on cigarettes and booze and, by much smaller majorities, on snack foods and soft drinks.

Obama’s non-starter of a plan to cap the value of deductions for top-bracket taxpayers was favored 55 percent to 40 percent in a June Quinnipiac College poll, although it has been a while since anyone has thought much about that plan.

And an across-the-board tax increase? Just 29 percent of those surveyed support that, according to a June Kaiser poll. With 60 percent in that survey believing that more uninsured can be covered at no cost at all, these results send a powerful and depressing message to Capitol Hill: Without a much better sales job, anything short of free lunch reform will generate a significant public backlash. Good for the critics. Bad for significant changes in the way we deliver and pay for medical care.     

What if we helped pay for health reform by raising the floor on deductible medical expenses from 7.5 percent of adjusted gross income to 10 percent? That, at least, is an idea leaked to The Wall Street Journal earlier this week by the Senate Finance Committee

The move, which TPC figures would raise about $23 billon over 10 years--about 2 percent of the likely cost of health reform--would lift the floor that was set back in 1986. To get a sense of what it would mean, I asked TPC’s Jeff Rohaly and Rachel Johnson to run some quick numbers.

But first, here’s how the deduction works today: Few taxpayers qualify for the medical expense deduction—only about 6 percent. Those facing catastrophic medical costs will get an average tax benefit this year of about $1,000, while those who benefit the most—taxpayers making more than $1 million--come away with almost $8,000.

It is no surprise that the wealthy do best in this structure. They always do with deductions, as opposed to credits. In addition, I suspect that thanks to the advice of accountants and lawyers, higher income taxpayers are better positioned to time discretionary medical expenses to take maximum advantage of the deduction. 

The other folks who do relatively well with this tax break are seniors. Almost 11 percent take some advantage of the deduction, twice the population at large, and they get an average deduction of $1,500. Most are clustered at incomes of between $50,000 and $200,000. Almost one-third of those making between $75,000 and $100,000 take a medical deduction, and they get an average benefit of about $1,200. Top-bracket seniors do far better. Those making between $500,000 and $1 million enjoy an average tax benefit of more than $6,500, while those earning $1 million-plus get about $9,500.

Raising the floor on tax-deductible medical expenses would chip away at some of those subsidies, but not by much. One reason may be that those hit by the Alternative Minimum Tax already face the 10 percent floor. So, for them, the change won’t matter.

Here are a few numbers: Most of those who get nicked are in the $50,000 to $200,000 income range. They’d face almost three-quarters of the tax increase. But on average, those making between $50,000 and $75,000 would lose only about $170 in tax benefits, while those making between $100,000 and $200,000 would lose roughly $450. At the very top, those making more than $1 million would lose more than half of their tax break, but would still end up saving $4,500. 

Bottom line: This proposal will stir a major fuss in return for relatively little money. Replacing the entire patchwork system of health care tax breaks with a single credit, as John McCain and others have proposed, might make a lot more sense. But that idea doesn’t seem to be on the table. 

    

Note to critics of the public plan option for health insurance: This debate is over. You lost. In 2007, more than 45 percent of all medical costs in the U.S. were paid by government, vastly more than the one-third funded by private insurance.   

Many Americans already have access to public coverage. There is Medicare for those over 65, Medicaid for the poor, SCHIP for kids, coverage for the active military, and for many veterans. Together, the share of medical spending paid by government has grown from one-third in 1970 to nearly half today, according to the Current Population Survey. If your definition of “public plan” includes insurance available through highly-regulated private carriers to federal, state, and local employees, the numbers are even bigger. And, of course, there is the quarter-trillion dollar government tax subsidy for health insurance.  

But even using the most narrow definition—those getting direct government coverage-- more than 80 million Americans already have such insurance. That’s half as many as have employer-sponsored insurance, but it’s still a lot of policies.   

Of course, among those 65 and older, far more have Medicare than have private coverage (many have both). Nearly a quarter of all children under 18 are covered by the government.

Public plans have been a pillar of health insurance in the U.S. since the 1960s. We can have a perfectly good argument about whether these plans work as well as they should, whether there are markets where private insurance is more appropriate than public coverage, or how we should structure a public plan. But talking about government coverage as if it is the insurance equivalent of a four-leaf clover is just bizarre.  

It is especially odd to hear the American Medical Association grumble about public insurance. Back in the 60s, the AMA opposed creation of Medicare and Medicaid, never imagining that government would pay about one-quarter of the cost of physician office vists and clinical services as it does today.

It is no surprise that critics of health reform would revive the old Harry and Louise argument that government is trying to take over your health care. But if that’s a problem, it has been one for decades.    

Senate Finance Committee Chairman Max Baucus (D-MT) is floating the following trial balloon: Congress would fund part of health reform with a cap on the tax exclusion of employer-sponsored health insurance but only at a level “significantly above” the cost of the standard plan offered to federal employees. The measure would also exclude policies bargained under current union contracts. In a bit of unsenatorial understatement, Baucus told reporters on Tuesday that this version of the cap “wouldn’t affect very many people.” Or, he might have added, raise very much money.

So why would Baucus push so hard for a cap that doesn’t tax many policies? My best guess: He’s playing the old camel’s nose under the tent game—getting the tax hike on the books even though it won’t raise much revenue for years.

It is simple to design such a plan. Just allow generous tax-free policies today, but freeze tax-exempt premiums at current levels. Over time, medical inflation will do the rest. As the costs of health care (and premiums) rise, that fixed cap will hit more policies.

Remember the rules of the game. President Obama says health reform must pay for itself, but over 10 years. That opens the door to a back-loaded tax system that generates relatively little today, but big bucks by the end of the decade. 

It is all about how you index the cap. And I suspect that’s where Baucus is headed. Various forms of inflation adjustments may seem like mere technicalities to voters—a definite plus for politicians—but the way you index a cap turns out to be a very big deal.

To see why, TPC took a preliminary look at three options—indexing the tax-free premium level to medical cost inflation (the most generous design), tying it to growth in the Consumer Price Index, or not adjusting at all for inflation, effectively freezing the cap indefinitely. In one model, indexing to medical costs would generate just $62 billion in income taxes over 10 years, while not indexing it all would raise 10 times as much, or more than $600 billion. Indexing to CPI would generate about $450 billion.

For an idea of how fast revenues build if the tax-free premium is not adjusted at all for inflation, the design TPC modeled would raise just $7 billion in 2010, but $136 billion in 2019. Keep in mind that the plan we used (about $5,600 for singles and $13,800 for family coverage) was probably less generous than what Baucus has in mind, but you get the drift.

Now, a cynic may say an unindexed cap is unsustainable--pressure would build to raise it as inflation eats away at the value of a tax-free policy. That may be true, but it isn’t Baucus’ problem. He’ll get credit from the Joint Tax Committee based on the assumption that his plan will remain in place.      

In a sense, Baucus may be trying to avoid a replay of catastrophic health reform back in the late 1980s. Old Washington hands remember that Congress passed a law to cover high-cost medical expenses, but had to repeal it even before it took effect. Why? Because it was easy for critics to gin up opposition to a measure that raised taxes right away but didn’t boost benefits for years. That may have been fiscally prudent, but it was a political disaster. Baucus, it seems, isn’t going to that mistake again.    

    

Until now, unions have been among the strongest critics of paying for health reform by limiting the tax exclusion for employer sponsored insurance. But on Monday, a well-connected labor lobbyist told me a deal could be done. “It all depends,” he said, “on what the cap looks like.”

Remarkably, in just a few weeks, lawmakers seem to have moved beyond the argument over whether the exclusion should be capped. Now, they are debating how. It is not easy. There are caps based on employee income, the value of the insurance, or both. There are caps tied to the actuarial value of coverage, or linked to geography. Then, there is the issue about how to index a cap.

First, a bit of boilerplate: Today, workers can get tax-free health coverage from their employer. Because this subsidy is excluded from taxable income, it is worth more to high-bracket workers than to those earning less. And the exclusion is very costly. In 2007, it reduced federal revenues by nearly $250 billion—about $145 billion in income taxes and $101 billion in payroll taxes.

With that kind of dough on the table, even a cap on the exclusion is a tempting way to help pay for a health reform. But what should it look like? 

If the goal is to raise cash, the simplest option may be to put a ceiling on the value of tax-free insurance. President Bush’s Tax Reform panel, for instance, would have limited the exclusion to $5,000 for single coverage and $11,500 for families, and indexed the cap to the Consumer Price Index. Because health premiums rise so much faster than the CPI, this design rapidly erodes the value of the tax break and raises lots for the Treasury.

But the commission's job was to reform taxes, not health policy. The Urban Institute’s Stan Dorn, seeking a more equitable exclusion, would tie the cap to the actuarial value of policies, not their price. In other words, benefits more generous than average would be taxed. Paul Van de Water, however, argues that such a structure would be too complicated to administer and might discourage employers from offering higher-quality plans.

While Stan would look to the value of benefits to measure “fairness,” others have different benchmarks. For instance, lawmakers from states where health costs (and, thus insurance premiums) are higher than average favor some geographic adjustment to the cap. Paul Fronstin found typical premiums for the same type of policy can vary by nearly 60 percent among states. Small business premiums can vary by more than 100 percent from state to state.

A regional adjustment may be politically attractive in the Senate, but it will also soak up a lot of potential revenue. Rather than scaling back the subsidy from a national average in lower-cost states, Congress is instead likely to just sweeten it for high-cost jurisdictions.     

Finally, some unions to prefer to base a subsidy cap on worker income rather than the value (however measured) of the insurance. Labor’s interest in this matter is no surprise since unionized workers are far more likely to have coverage that exceeds the Tax Panel’s limit than employees of non-union shops, according to a Tax Notes article by Eliza Gould and Alexandra Minicozzi. At the same time, union wages may well fall below an income cap.

Lots of really interesting policy questions to chew over, and no obvious answers. TaxVox will look more closely at each of these ideas over the next few weeks.           
 
         

As promised, TPC has crunched some numbers for the health reform plan introduced by congressional Republicans last week. They are pretty ugly, and an indication of just how hard it is to confront the taxation of medical care.

The Patient’s Choice Act, sponsored by Representative Paul Ryan (R-WI), Senator Tom Coburn (R-OK) and others, takes some remarkable steps toward bipartisanship by embracing regional purchasing pools. It also includes some very Republican ideas, such as giving low-income families $5,000 to buy their way out of Medicaid.

But most interestingly, it proposes a generous tax credit of $2,300 for singles and $5,700 for families to help buy private insurance. And it would pay for this new subsidy by repealing the tax exclusion for employer-sponsored insurance. The authors have left out some key details, such as whether the credit would be refundable, how it would be indexed for inflation, and whether employer-paid premiums would be subject to Social Security and Medicare payroll taxes.

So, TPC’s health modeler Surachai Khitatrakun ran several options. And he found the GOP is faced with a painful choice: It can design a credit-for-exclusion swap that won’t bust the budget. But to do so, the plan would end up raising taxes on people making less than $50,000. That’s both a bad idea and a political non-starter.

If the exclusion is made non-refundable, and if workers have to pay payroll taxes on their health insurance, the trade-off would actually boost revenues by about $200 billion over 10 years. Income taxes would fall by $1.1 trillion, but payroll taxes would rise by even more--$1.3 trillion. Unfortunately, most of that extra tax burden would end up on the backs of those making $50,000 or less. Those making between $20,000 and $30,000 annually would see their taxes rise by about $260 and their after-tax income fall by more than 1 percent

Every other option TPC looked at risks becoming a major revenue sink. For instance, if the credit is made refundable, as it probably should be, and employer insurance is subject to payroll tax, total federal revenues would fall by nearly $600 billion over the decade. If the credit is refundable and the value of insurance remains exempt from payroll taxes, the swap would cost a staggering $1.7 trillion over a decade. Not much chance Congress will buy a plan that costly when it already faces such huge deficits. 

If the credit is refundable, the swap becomes pretty progressive. Those making an average of $15,000 would get a tax cut of roughly $700 and see their incomes rise by about 5 percent. Taxpayers with an average income of $70,000 would see their after-tax incomes rise as well, but only by about 2.3 percent. The top 10 percent of earners would end up paying roughly the same tax as they do now. 

By the way, for all of these models, TPC assumed the credit would be indexed to an average of the growth in the consumer price index and medical costs. If it is tied just to CPI, the credit would quickly become far less generous, though, of course, Treasury would also lose less revenue.

So, it seems policymakers are left with three choices: They can make the exclusion-for-credit swap progressive and expensive, they can make it regressive and cheap, or they can propose a much more modest credit. No one ever said this was going to be easy.  

 

Yesterday, conservative Republicans rolled out their health reform plan. The Patient’s Choice Act is an interesting mix of Massachusetts-like exchanges and other reforms intended to boost the individual insurance market. But, no surprise, its centerpiece is a giant tax cut.

 

The tax plan is not new. It is, in fact, a version of John McCain’s presidential campaign plank. The measure, sponsored by Senator Tom Coburn (R-OK) and Representative Paul Ryan (R-WI) would replace the exclusion for employer-provided health insurance with a generous tax credit ($2,300 for individuals and $5,700 for families). The price tag for the McCain version (a refundable credit of $2,500 and $5,000): $1.3 trillion over 10 years.

 

A credit subsidizes taxpayers of all incomes more or less equally (unlike the exclusion, which is worth more to high-bracket workers). And it is a very sweet deal, at least at first. For someone in the 25 percent bracket, a $5,700 credit is worth roughly as much as the exclusion for a $23,000 insurance policy. You can buy a lot of insurance for $23,000—perhaps too much.  

 

However, the GOP proposal is silent on two key issues: Will the credit be refundable and how will it adjust for inflation?

 

If the credit is not be refundable, as McCain’s was, the plan would be much less expensive, but would also leave millions of low-income workers without a subsidy. If it is refundable, the cost would likely be close to McCain's version--$1 trillion or so. Supporters say Coburn and Ryan also favor a separate $5,000 cash grant to help very low-income people buy private insurance in lieu of Medicaid.        

 

Then there is the matter of whether the credit would be indexed for inflation and, if so, how? When TPC estimated the effects of the McCain plan, it assumed the credit would rise with the consumer price index. Because the CPI increases more slowly than medical costs, the value of the credit would gradually decline.

 

Unfortunately, the McCain version would not have done much to increase the number of Americans with health insurance. About 21 million more people would get insurance in the individual market, but 20 million would lose employer coverage once the exclusion is killed. In all, a lot of aggravation for very little benefit.

 

Still, McCain, Coburn, and Ryan are on to something here. It makes sense to start phasing out the exclusion while expanding the credit. The problem is that, at least for now, there is no real individual market where people can buy insurance.

 

To build one, the GOP bill borrows from, gasp, Hillary Clinton, by proposing regional purchasing pools and requiring insurance companies to sell to all comers regardless of their health. But the plan includes only a vague and complex proposal to restrict the ability of carriers to cherry pick the healthiest customers, and no mandate to buy. A lot of holes still need to be filled in.

 

However, the optimist in me (yes, he’s in there someplace) says if Tom Coburn and Paul Ryan can talk about exchanges and guaranteed coverage along with a new health care tax structure maybe there is a deal to be done after all.       

    

 

 

Describing  his financing options for health reform yesterday, Senate Finance Committee Chairman Max Baucus (D-MT) delivered two messages: A) Eliminating the tax exclusion for employer-sponsored health care is off the table and B) He would still like to find a way to curb this hugely expensive and inefficient subsidy.

Baucus' bipartisan alternatives for limiting the exclusion cover the proverbial waterfront. Congress could cap the subsidy based on the value of the insurance plan, the income of the policyholder, or both. It could index the cap based on health care inflation, the consumer price index, or growth in GDP. It could “grandfather” existing union-negotiated plans, or not. What Baucus seems to be saying is: I’ll do whatever it takes to reduce the value of the exclusion, even if it is only a small step toward eventual repeal.

The differences among these designs may seem technical, but they make a huge difference in terms of fairness, the future of health coverage, and the amount of money they raise.

Take the dollars. TPC has looked at several of Baucus' options. Repealing the exclusion outright would generate $3.5 trillion over 10 years, more than enough to pay for any reasonable health reform. Freezing the exclusion at today's level without adjusting the cap for inflation would generate about $1.1 trillion. Because health care costs rise so much faster than overall inflation, indexing the exclusion to CPI would still produce about $850 billion. But linking the cap to the annual health cost increases would produce only about $165 billion.

But it is about more than just revenues. Think about two ideas—tying a cap to the value of insurance or linking it to the income of the policyholder.

Congress could accomplish the first by allowing taxpayers to exclude from income only the value of insurance equal to the standard health plan offered to federal employees. In other words, workers would have to pay tax on plans that are worth more than the coverage lawmakers themselves get. It is not so easy to compare the actuarial value of insurance provided by a five-employee company with the federal government plan, but it is possible. And it would roughly accomplish the goal of curbing tax subsidies for “gold-plated plans.” This design, however, would also raise questions about what to do about people who live in places where the cost of medical care is unusually high.

Alternatively, Congress could cap the tax subsidy only for high-income taxpayers, no matter what insurance they buy. This is yet another tax increase on the rich, but it is hard to see how it would encourage a more efficient health system. It is easier to imagine business owners dumping coverage if they have to pay higher taxes on the benefit than their workers.

This is complicated stuff. As it happens, I moderated a panel this morning on tax subsidies for health care. I asked my fellow panelists what they’d do with the exclusion. All agreed that it has got to go, at least over time. But when I asked what kind of a cap they preferred, one voted to tie it to premiums, another preferred linking to income, and the third favored a combination. I suspect Congress will have just as hard a time reaching a consensus on this.

Medicare’s Part D drug benefit is going to cost taxpayers a lot of money. A really, really lot of money.

You can find the story deep in the bowels of the Medicare Trustees report that was released earlier this week. It is a nice little case study of how a well-intentioned government program can add tens of billions of dollars annually to the federal deficit. And it is a cautionary tale of how hard it will be to bring medical costs under control, despite the promises of the Obama Administration and industry lobbyists.

Part D was adopted by Congress in 2003 and began to pay full benefits in 2006. When Congress passed the drug program, conservatives groused that it was too expensive, while liberals complained it was both too complicated and not generous enough.       

Premiums finance only about 25 percent of the program’s cost—the rest is paid through general tax revenues. Unlike Part A hospital insurance, there is no payroll tax funding for this piece of Medicare. 

For the past three years, benefits have been significantly lower than government actuaries first projected, in part because so few costly new drugs have made it on to the market. But don’t worry. That bit of fiscal good fortune is not likely to last long.

According to the actuary’s intermediate cost assumptions, Part D spending will nearly triple from about $50 billion last year to a staggering $140 billion in 2018. Per capita spending will more than double, from $1,500-a-year to almost $3,200. And the program’s long-run costs are even more troublesome: growing from about 0.4 percent of Gross Domestic Product in 2008 to 1.4 percent of GDP by mid-century to 1.8 percent by 2080. Yikes. That’s about 10 percent of what it has historically cost to run the entire federal government.

Just as troubling is the uncertainty of these estimates. While $140 billion is the mid-range forecast for 2018, the actuaries warn the cost could range from as low as $107 billion to as much as $180 billion. With admirable understatement, the trustees say, “there remains a very substantial level of uncertainty surrounding these costs projections.”

It is probably worth adding that these are net drug costs. Presumably, some of these medications will reduce other medical expenses by keeping people out of hospitals, and by avoiding surgeries and other costly treatments. That is surely an argument that the pharmaceutical industry will make when the White House asks it to do its part to trim medical expenses by 1.5 percent.      

But how will we ever know? Reducing $140 billion by 1.5 percent would save only about $2 billion. And that is so far within the estimating error that it is little more than loose change under the statistical sofa cushions.

The drug benefit was a sensible reform. It was absurd that in 2003 Medicare was still offering health insurance that excluded pharmaceutical drugs. But those House conservatives were right about one thing: Part D will be hugely expensive. And we need to find a way to pay for it.

 

Today’s letter from key health industry players to President Obama promising to “do our part” to control medical care cost growth is a big deal. It sends a powerful message that “Harry and Louise,” the fictional couple who became the symbol of the medical establishment’s opposition to Clinton-era health reform, have retired to a condo in Florida.

Instead of sitting the sidelines saying “nyet” to reform, influential providers, drug and medical technology firms, and insurance companies now understand the proverbial train is leaving the station. Their role is no longer to oppose reform, it is, instead, to tailor reform to their own interests. That is a profound change. 

But make no mistake, for now their promise to trim 1.5 percent off of expected health care cost growth over the next decade is little more than rhetoric. Their two-page letter contains many platitudes but no specifics. It touches all the usual bases: transparency, aligning quality and efficiency; evidence-based best practices, coordinating care, disease prevention, and health information technology. But it promises nothing.

And while the health industry is widely represented in this missive, one interest group is conspicuously missing: consumers. And in the end, unless patients are willing to accept the consequences of all these clichés—which is to say, sometimes they will not get costly treatments they think they deserve—none of these promises will be worth the price of a used bedpan. No politician will stand up to the kind of consumer revolt that sunk most of the managed care movement  in the 1990s, even though the HMOs of those days promised many of the very same reforms that are in today’s letter.

And keep in mind that even the kind of massive change these groups promise is still unlikely to pay the full cost of health reform. President Obama acknowledged that in his own way today, with an expanded set of tax hikes intended to fund about half of a $600 billion health reform reserve fund. Even the full $600 billion would pay for less than half the cost of the President’s campaign version of health reform, TPC estimates.

I’ll talk some more about those tax hikes tomorrow. But for now, the take-away is this: Even with the best of intentions, it will be exceedingly difficult for providers and insurers to trim $2 trillion from expected cost growth over the next decade. The changes industry promised today are a welcome step in the right direction but won’t avoid tax increases. In many ways, they highlight just how important new revenues will be to reforming the way we all get medical care.
 

There are already signs that a key tax element of President Obama’s budget--his proposal to limit to 28 percent the value of all tax deductions—may not survive on Capitol Hill. And if it is allowed to die, Congress may find itself staring squarely at another hard-to swallow tax hike—trimming the tax exclusion for employer-sponsored insurance. Key Republicans have strongly objected to the curb on deductions. Powerful Democrats, including Finance Committee chairman Max Baucus (D-Mt), are less than enthusiastic. Charities that fear they will lose contributions are gearing up for a big fight, even though TPC estimates that gifts would decline by only about 2 percent. And in the face of this criticism the Administration has signaled that it may not fight very hard to save the proposal. "We recognize there are other ways to do this," Treasury Secretary Tim Geithner told the Finance panel yesterday.    more »

To help pay for health reform, President Obama’s wants to limit deductions for high income taxpayers. He’s on to something, but I’ve got some questions about what he’s doing. This tax increase, sure to be politically contentious, would kick in starting in 2011 and raise about $318 billion over 10 years. That sounds like a lot, but in fact it would only fund about 20 percent of the total cost of the health plan Obama outlined in his presidential campaign. TPC estimated the price of that plan at $1.6 trillion over 10 years.    more »

I am sure Barack Obama will deliver a stirring Inaugural address tomorrow. However, Obama’s most important remarks since his election came in an interview the other day with The Washington Post. There, he promised to convene a bipartisan fiscal summit in February. This has the potential to be the most important step of his Presidency. Yes, at least as important as fixing the immediate economic mess.    more »

It seems paradoxical, but some well-connected health reformers are arguing that a costly remake of U.S. insurance may be more likely in the wake of the economic slump. Their theory: Since we are already spending hundreds of billions to bail out the financial system and since the Obama Administration is likely to pump out a similar amount in fiscal stimulus early next year, the time may be right to spend a few hundred billion more on health coverage for the uninsured.    more »

Well, not exactly. But I wanted to get your attention. Senate Finance Committee Chairman Max Baucus (D-Mt.) has unveiled a blueprint for major health reform. And it includes a call for scaling back the tax benefits of employer sponsored insurance. Baucus has put on the table a variation of John McCain’s plan to scrap that benefit and use the money to finance a refundable credit for anyone buying insurance (either in the individual market or though their employer). This would be the very same idea that Barack Obama so frequently ripped as a massive tax increase on your health care.    more »