Excise Tax on High-Cost Health Plans.  New 40% excise tax on health insurance plans to the extent they exceed $26,000 in cost ($9850 single).  Exemptions made for over-55 retirees and “high-risk” professions; high-cost states phased in

Individual Mandate Tax.  If you don’t sign up for health insurance, you will have to pay a tax in the following range:
 

Employer Mandate Tax.  $400 per employee if health coverage is not offered.  Note: this is a huge incentive to drop coverage, as $400 is much less than the average plan cost of $11,000 for families or $5000 for singles (Source: AHIP)

Backdoor Death of HSAs.  By requiring that all plans (besides the few that are grandfathered) provided actuarially-generous coverage for most services, there would be no HSA-qualifying plans available from the Massachusetts-like exchanges

Report Employer Health Spending on W-2.  This is clearly a setup for the easy individual taxation of employer-provided health insurance down the road.

Cap Flex-Spending Account (FSA) Contributions at $2500. Currently unlimited.

Eliminate tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D

Medicine Cabinet Tax.  Americans would no longer be able to purchase over-the-counter medicines with their FSA, HSA, or HRA

Increase Non-Qualified HSA Distribution Penalty from 10% to 20%.  This makes HSAs less attractive, and paves the way for HSA pre-verification

Corporate 1099-MISC Information Reporting.  Currently, only non-corporations providing property or services for a business must be issued at 1099-MISC.  This would expand the requirement to corporations doing business with other businesses. 

Various industry tax grabs based on market share. $2.3 billion PhRMA; $6 billion health insurance providers; $4 billion medical device manufacturers

Increase “haircut” of medical itemized deductions from 7.5% to 10% of adjusted gross income (AGI)

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Posted by Ryan Ellis on Monday, October 12, 2009 3:42 PM EDT

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