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Tax increases abound in healthcare reform legislation

Posted by Jamie Downey  December 22, 2009 06:17 AM

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Last night I spent a little time looking at the health care reform legisilation that passed the Senate, a.k.a H.R. 3590 Patient Protection and Affordable Care Act.  I did this since I know that neither John Kerry nor unelected Senator Paul Kirk have read the bill.  While it would take days to read the entire bill, my cursory review of the legislation identified at least 19 tax increases. 


Just an FYI to Mr. Kerry and unelected Sen. Kirk, we already have a universal health insurance law here in Massachusetts.  As I read it, this legislation will provide no additional health insurance coverage to the residents here in Massachusetts, only additional taxes.  But I digress. 


The following are some of the highlights of the tax increases included in the bill:


Section 1501 - Requirement to maintain minimum essential coverage - Individuals will be required to maintain health insurance.  Those that do not will be assessed an annual tax penalty of $750.  The tax penalty is scheduled to escalate in subsequent years.  Consequently, Massachusetts residents that do not maintain health insurance will be assessed a tax at both the state and federal level. 


Section 9001 – Excise tax on high cost employer-sponsored health coverage – This provision levies an excise tax of 40 percent for any health coverage plan that is costs over $8,500 per year for single coverage and $23,000 per year for family coverage.   Since this was protested vigorously by unions and public employees, the Senate caved and granted a massive concession.  The tax is not levied on the individual receiving the tax free benefit, but is levied on the insurance company or plan administrators that provide the employee the benefit.  How absurd is that? 


Section 9008 - Imposition of annual fee on branded prescription pharmaceutical manufacturers and importers - This piece of the legislation imposes a $2.3 billion excise tax on the pharmaceutical industry.  The tax is allocated across the industry and is based on market share, not on income.  This tax starts immediately and is non-deductible for the corporation being taxed.   These companies will still be required to pay their federal income taxes.


Section 9009 - Imposition of annual fee on medical device manufacturers and importers - This section imposes a $2 billion excise tax on the medical device industry.   The fee is allocated across the industry based on market share, not on income.  This tax starts immediately and is non-deductible for the corporation being taxed.  


Section 9010 - Imposition of annual fee on health insurance providers - Another excise tax.  This one is assessed on the health insurance industry in the amount of $6.7 billion per annum and is also based on market share. How can the imposition of $11 billion in excise taxes (section 9008, 9009 and 9010) on the health care industry reduce costs to consumers?  Does anyone else suspect these companies will have to pass these costs over to consumers?


Section 9013 - Modification of itemized deduction for medical expenses – For those incurring significant medical costs, your ability to deduct these expenses will be decreased.  This legislation increases the adjusted gross income threshold for claiming an itemized deduction from 7.5 percent to 10 percent.  


Section 9015 - Additional hospital insurance tax on high-income taxpayers – This increases the Medicare tax on wages by 0.50 percent on individuals making in excess of $200,000 and married couples making over $250,000.  This will be effective starting January 1, 2013.  (As a side note, individual income taxes are already scheduled to increase in 2011, with the highest rate already increasing by 4.6 percent. This will be in addition to the tax increase as outlined here in Section 9015.)


Section 9017 - Excise tax on elective cosmetic medical procedures - The bill imposes an excise tax of 5 percent for any voluntary cosmetic procedures. 


The bill is now off to reconciliation and it may take some time for an agreement.  Fortunately, if elected, we know Mrs. Coakley will not vote for the bill.  She has made it clear that her only concern is that the bill ensures federally funded abortion coverage for all.  (Apparently, abortion is a noble cause worthy of her leadership.)  


Mr. Kerry’s yes vote is secured.  He has never paid any Medicare taxes.  Furthermore, the only additional taxes I see that he and his family will incur is the excise tax for voluntary cosmetic surgery.

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