We cannot verify your location
Browse Book and Journal Content on Project MUSE
OR

Using Taxes to Reform Health Insurance

Pitfalls and Promises

edited by Henry J. Aaron and Leonard E. Burman

Publication Year: 2008

Few people realize that one of the nation's largest health programs runs through the tax system. Reformers of all stripes propose to modify current tax rules as part of larger programs to increase coverage and control costs. Is the current system working? Will tax-based reforms achieve their goals? Several of the nation's foremost experts on taxation and health policy address these questions in Using Taxes to Reform Health Insurance, a joint product of the Urban-Brookings Tax Policy Center and the American Tax Policy Institute. Led by respected economists Henry Aaron of the Brookings Institution and Leonard Burman of the Urban Institute, contributors examine the role taxes currently play, the likely effects of recently introduced health savings accounts, the challenges of administering major subsidies for health insurance through the tax system, and options for using the tax system to expand health insurance coverage. No taxpayer or consumer of health care services can afford to ignore these issues.

Published by: Brookings Institution Press

Cover

pdf iconDownload PDF
 

Table of Contents

pdf iconDownload PDF
pp. v-vi

read more

Acknowledgments

pdf iconDownload PDF
p. vii

We thank Robert Faherty and the staff of Brookings Institution Press for their efforts in publishing the volume and are grateful to Diane Hammond and Anthony Nathe for expert editing. ...

read more

1. Introduction

pdf iconDownload PDF
pp. 1-12

Following the collapse of President Bill Clinton’s health reform proposal in 1994, most elected officials became unwilling to talk about major government action to change private health insurance arrangements. Democrats were shell-shocked by the political fallout from the Clinton debacle, ...

read more

2. Tax Policy and the History of the Health Insurance Industry

pdf iconDownload PDF
pp. 13-35

For the last six decades, health insurance coverage has been provided primarily through policies offered to workers at their place of employment. In 2006 employer-based insurance covered 161.7 million people, approximately 62.2 percent of the nonelderly population.2 ...

read more

3. The Tax Code, Employer-Sponsored Insurance, and the Distribution of Tax Subsides

pdf iconDownload PDF
pp. 36-66

About 46 million Americans under age sixty-five, including 9 million children, lack health insurance. They receive less preventive care when healthy and poorer care when sick than do the insured. Furthermore, the public ultimately shoulders much of the burden of paying for the medical treatment of the uninsured, ...

read more

4. Health Savings Accounts: Recent Trends and Potential Effects on Coverage and Health Insurance Markets

pdf iconDownload PDF
pp. 67-91

In 2003 the Medicare Prescription Drug, Improvement, and Modernization Act (also called the Medicare Modernization Act or MMA) established health savings accounts (HSAs), which allow tax benefits for out-of-pocket health spending when paired with a high-deductible health insurance plan (HDHP).1 ...

read more

5. What's in a Name? Are Health Savings Accounts Really Health Savings Accounts?

pdf iconDownload PDF
pp. 92-118

Health savings accounts (HSAs) are tax-sheltered savings instruments available to people under the age of 65 who buy high-deductible (HD) health insurance. Chapter 4, by Lisa Clemans-Cope, describes the origin of and rules governing HSAs. Together with high-deductible health insurance, HSAs compose ...

read more

6. Tax Subsidies for Out-of-Pocket Health Care Costs

pdf iconDownload PDF
pp. 119-146

Each year, around the time employers have open enrollment for their benefits plans, newspapers publish stories headlining that employer-provided health insurance is becoming less generous. A 2003 New York Times story observed that “employers are shifting a growing share (of costs) onto people who make the heaviest use ...

read more

7. Administrative Issues: Challenges of the Current System

pdf iconDownload PDF
pp. 147-170

Many of the major health care reform proposals would assign a key administrative role to the IRS. To those who would rely heavily on IRS involvement, we say: Beware! The IRS’s track record in administering the existing, relatively simple tax rules governing health care is not heartening. ...

read more

8. The Challenges of Implementing Health Reform thorough the Tax System

pdf iconDownload PDF
pp. 171-210

Designers of fundamental health reform proposals often use the income tax system to achieve their goals. These goals include expanding health insurance coverage while containing the growth of medical costs. Health reform proposals may use the Internal Revenue Service (IRS) to enforce mandates requiring individuals ...

read more

9. Reforming the Tax Treatment of Health Care: Right Ways and Wrong Ways

pdf iconDownload PDF
pp. 211-229

Health care in America faces three fundamental problems. First, according to census estimates 47 million Americans are uninsured.1 Second, America spends an enormous amount on health care for the insured while often getting little or no benefit at the margin.2 And third, health care is the largest source of the long-run fiscal gap.3 ...

read more

10.Simple Humans, Complex Insurance, Subtle Subsities

pdf iconDownload PDF
pp. 230-262

The behavioral revolution in economics tells us that human beings often have difficulty making wise choices. The most widely chronicled difficulties in decisionmaking occur in conjunction with decisions made under conditions of uncertainty, decisions that involve significant elements of time, ...

read more

11. Taxes and Health Insurance

pdf iconDownload PDF
pp. 263-270

The single most important factor influencing the federal government’s long-term fiscal balance is the rate of growth in health care costs. Without any changes in federal law, the Congressional Budget Office projects that total spending on health care will rise from 16 percent of the GDP in 2007 to 25 percent in 2025 ...

Contributors

pdf iconDownload PDF
pp. 271-272

Index

pdf iconDownload PDF
pp. 273-282


E-ISBN-13: 9780815701972
E-ISBN-10: 0815701977

Page Count: 282
Publication Year: 2008

OCLC Number: 567901475
MUSE Marc Record: Download for Using Taxes to Reform Health Insurance