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:
| Single | Family | |
| 100-300% FPL | $750 | $1500 |
| 300% + FPL | $900 | $1900 |
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)