FISCALLY FIT
By TERRI CULLEN         

Tax Break or Burden?
Terri Investigates Whether Bush Health Plan
Would Help or Hurt the Cullens' Bottom Line
January 25, 2007

This week President Bush proposed a radical change in the way the
government taxes health insurance, in an effort to spur more
individuals to buy coverage.

The president didn't offer a lot of specifics in his speech, but
according to a fact sheet1 released by the administration, his
proposal would work something like this: Taxpayers with
health-insurance coverage wouldn't pay federal income or payroll taxes
on the first $15,000 of income -- $7,500 for singles. That income
exclusion is slightly higher than the average cost of health
insurance: According to the Kaiser Family Foundation, the annual
premium for an employer health plan covering a family of four averaged
about $11,500 in 2006, with single coverage averaging slightly more
than $4,200.

However, for the first time, the cost of employer-provided health
insurance would be considered taxable income for the worker. Right
now, insurance premiums paid for by employers are exempt from income
and payroll taxes. Self-employed workers generally are allowed to
deduct the cost of health-insurance premiums from taxable income.

Under the proposed plan, if your health-care premiums total less than
$15,000, your tax bill should go down. According to the
administration, a household earning $60,000 would save about $4,500 in
taxes under the proposal, including $2,250 in income-tax savings and
$2,250 in savings from payroll taxes for Social Security and Medicare.

But if your employer pays for a pricey comprehensive health-care plan,
your taxes could rise. As my print colleague Alan Murray noted in his
column5 on the Bush proposal, that tax increase would likely be borne
by union members and high-paid executives.

The proposed tax change was first floated by the president's advisory
panel on federal tax reform back in November 2005. One of the panel's
assumptions was that workers preferred that their bosses pay for
insurance with untaxed dollars, rather than having to use after-tax
income to pay for it themselves. The panel also concluded that workers
with employer-sponsored health insurance spend more on health care
than they would if they had to pay for it themselves, which drives up
the cost of health care in general. The panel suggested that a tax
incentive to buy lower-cost insurance might result in more consumers
having coverage and spending less on health care.

I set out to determine what effect the Bush proposal might have on my
family's bottom line -- though, granted, there's no guarantee the
proposal will ever see the light of day.

My family's covered by a health-care plan through my husband Gerry's
labor union -- I opt out of my company's health-insurance plan. First,
I needed to find out how much Gerry's employer pays into his union's
welfare fund annually for our family's coverage. I had no idea what
our premiums cost, but I knew it had to be expensive because we have a
preferred provider organization plan, or PPO, with vision and dental
coverage.

It was relatively easy for me to find that number since the cost is
detailed in Gerry's labor agreement: $12,376. If you don't know how
much your benefits cost, and you want to play along at home, ask your
employer or benefits administrator. (If the tax change is implemented,
I presume employers will be required to report on your W-2 how much
your premiums cost along with your earnings. There's a separate debate
over how companies will determine how much an individual's health-care
coverage costs -- it may not be as simple as dividing the total cost
by the number of employees. But we'll leave that one alone this time
around.)

I hit my home computer and called up our 2005 tax returns on TurboTax.
I added the $12,375 for the health-insurance coverage that would be
counted as income under the new plan, then subtracted the proposed tax
break of $15,000 from Gerry's annual wages and salaries. That dropped
our federal income-tax bill to $27,593 from $28,364, for a savings of
$852.

So at first glance the new tax plan would benefit our family. But the
devil is in the details: Would that $15,000 income exclusion be
indexed for inflation? If so, would it be indexed for inflation or
health-insurance-premium inflation? In 2006, medical costs rose 3.6%,
while the consumer price index rose just 2.5%, according to the Bureau
of Labor Statistics. But health-insurance premiums jumped even higher
last year, up 7.7%, according to the Kaiser Family Foundation, and
premiums are predicted to continue to outpace consumer inflation going
forward.

A 7.7% increase in health-care premiums would increase the cost of our
health-care plan -- and, therefore, our income -- by $13,328 under the
proposed plan, shaving about $65 off our hypothetical tax savings. If
that continued, within a few years our costs would cross the $15,000
threshold, and we'd end up with a bigger tax bill. Unless the break is
indexed to account for rising premium costs, it's easy to see how it
might morph into a growing burden similar to the alternative minimum
tax, which was never indexed for inflation and is now unintentionally
affecting millions of middle-income taxpayers. Once implemented, might
Congress become dependent on the increasing revenues generated by the
proposed health-insurance tax change, as it has with the AMT?

I also have to question whether the White House's proposal would have
the intended effect of nudging uninsured people into buying coverage
or prompting workers to drop out of expensive employer-sponsored
health-care plans and find more lower-cost coverage on their own.
Affluent workers would probably stick with their gold-standard health
plans rather than accept a lower level of service in return for a
relatively small tax break. And my experience growing up in a
low-income family makes me skeptical that many of these uninsured
workers would run out and buy health insurance because of a promised
tax break. (I'm assuming you'd have to pay health-care premiums for a
year before seeing any financial benefit from lower taxes.)
Middle-income workers would likely benefit most -- if the tax break is
indexed for premium inflation -- since many are already seeking out
more-affordable coverage on their own because their employers' plans
have become prohibitively expensive.

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