Thursday, May 25, 2017

10 ways the House healthcare bill cuts federal revenue

By Harris Meyer  | May 25, 2017

Congress' nonpartisan Joint Committee on Taxation on Wednesday released its estimate of the revenue impact of the tax provisions in the House Republicans' American Health Care Act.

It received less attention than the Congressional Budget Office's report on the bill's cost and coverage impact, which came out at the same time.

The AHCA would repeal or delay the Affordable Care Act's revenue provisions for financing the law's insurance coverage expansions and benefit enhancements. In total, the Joint Committee on Taxation found that the bill's tax provisions would slash federal revenue by $662.6 billion from 2017 through 2026.

Meanwhile, the CBO found that the bill's reductions in federal Medicaid spending and its repeal of the ACA's premium and cost-sharing subsidies would cut federal outlays by a total of about $1.1 trillion over 10 years.

Here are the specific 10-year sources of revenue reduction as estimated by the Joint Committee on Taxation:

1.       $172.2 billion from repealing the ACA's 3.8% tax on wealthy people's investment income.
2.       $144.7 billion from repealing the annual fee on health insurance premiums.
3.       $125.7 billion from lowering the income percentage threshold from 10% to 5.8% for deducting medical expenses; this was designed to give Senate Republicans budgetary room to sweeten premium tax credits for older consumers.
4.       $66 billion from delaying until 2026 the so-called Cadillac tax on high-value employer health plans.
5.       $58.6 billion from repealing the additional 0.9% Medicare payroll tax on wealthy people.
6.       $28.5 billion from repealing the annual fee on sales by manufacturers and importers of branded drugs.
7.       $19.6 billion from repealing the 2.3% excise tax on sales by medical-device manufacturers and importers.
8.       $19.4 billion from repealing limits on contributions to employers' flexible spending health plans.
9.       $5.6 billion from allowing nonprescribed over-the-counter drugs to be paid for from tax-sheltered health savings accounts and flexible spending accounts.

10.    $505 million from repealing the $500,000 annual deduction for health insurers in compensating individual executives.

Harris Meyer is a senior reporter providing news and analysis on a broad range of healthcare topics. He served as managing editor of Modern Healthcare from 2013 to 2015. His more than three decades of journalism experience includes freelance reporting for Health Affairs, Kaiser Health News and other publications; law editor at the Daily Business Review in Miami; staff writer at the New Times alternative weekly in Fort Lauderdale, Fla.; senior writer at Hospitals & Health Networks; national correspondent at American Medical News; and health unit researcher at WMAQ-TV News in Chicago. A graduate of Northwestern University, Meyer won the 2000 Gerald Loeb Award for Distinguished Business and Financial Journalism.

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