The article on VAT made a true statement---the US is one of a few nations not installing a VAT tax and this is why-----
OUR US CONSTITUTIONAL LAWS OF TAX UNIFORMITY, ANTI-TAX DISCRIMINATION LAWS-----THE VAT TAXES DO JUST THAT.
As I said, third world nations use this to soak the average citizen with taxation as global pols in the US intend to do----Europe used the VAT with a combination of other wealth and corporate taxation policies to balance the push to the bottom for European citizens. Think what Euro citizens have received for paying that progressively lower VAT ----free health care, free education, free public transit etc. That was the balance that is being dismantled by global pols in the US. They do not intend to have any balance---they are third world pols.
'NEO-'Liberals also love the VAT because of the way it makes every business an aggressive tax collector. Businesses pay the tax when they buy things, and then collect it from the next purchaser in the supply chain. The businesses get a rebate on the portion they paid when they remit to the government the sums they collected, so the system motivates all companies to ensure taxes are paid in full'.
'Suppose we used a value-added tax (VAT) to finance excessive health spending; using a VAT in this way would accomplish several goals and simultaneously mitigate general concerns about the VAT. Most importantly, the deficit could be controlled';
Below you see how this works into health care reform in US with the very Republican Affordable Care Act. Remember, both global Bush/Hopkins neo-cons and Clinton/Obama neo-liberals INTEND ON INSTALLING THE VAT-----they now have to pose progressive to Democratic base and pose conservative to to the Republican base not wanting higher taxes----and this is how it will look in national media. Republicans are already calling Affordable Care Act the biggest hike in taxes in US history-----and it appears so. The game is played around all workers having MEDICARE AND SOCIAL SECURITY PAYROLL TAXES taken out for future health care-----those are big taxes------being replaced by this VAT tax-----also big taxes. The posing comes from the fact global pols intend for US citizens to keep paying BOTH. If you see Medicare or Social Security being privatized and dismantled---you do not see the payroll taxes being removed---they are being shifted into WALL STREET 401Ks or IRA private investment. So, we will still be paying our payroll taxes for health care-----and they are looking to tax health care separately with this VAT. THAT WILL BE LOTS OF NEW TAXATION-----
REMEMBER----THE SOARING COSTS IN HEALTH CARE IN THE US IS DRIVEN BY HEALTH INDUSTRY FRAUD AND PROFITEERING----NOT HOW MUCH HEALTH CARE ACCESS AMERICANS RECEIVE---- global pols PRETEND the costs are driven by how much health care access Americans receive.
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“Inoculate the Budget from Health Care Reform,”
May 13, 2012 By VATinfo“The medium- and long-term deficits that will result from debt-financed health care spending will inexorably dampen economic performance. They will sap up capital, reduce our ability to grow, burden future generations with debt, and perhaps even influence the military and diplomatic stance of the country. We cannot, and indeed should not, wait for effective health care reform to rein in the budget deficit. Health reform is a process; it will take time to get it right as we learn about what works and what doesn’t. We won’t get it right on the first shot.
As we work to restrain health care cost growth, we must, at the same time, inoculate the future deficit from the inevitable failures of health reform.
We can do this by choosing a federal health care spending level and stipulating that any spending above that amount must be financed on a current basis with a tax. For example, if federal health care spending were allowed to grow at the rate of GDP plus 0.5 percent (a rate proposed by both President Obama and Rep. Ryan), any health spending in excess of that growth rate would be financed with tax revenues in the next year.
Suppose we used a value-added tax (VAT) to finance excessive health spending; using a VAT in this way would accomplish several goals and simultaneously mitigate general concerns about the VAT. Most importantly, the deficit could be controlled; the grinding economic effects of persistent long-term deficits could be avoided even before society resolves the economically difficult and politically treacherous questions raised by trends in health costs.
In addition, the proposal would link health care spending and the means to pay for such spending. When considering whether health spending should rise, voters would have an explicit choice between higher spending and higher taxes on the one hand or lower spending and lower taxes on the other.”
When a global pol uses the term VALUE-ADDED----it means policy brings and protects corporate profit without worrying about citizen interest. That is how VALUE-ADDED is used in the Affordable Care Act. This is why Republicans are going crazy with the goal of installing Value-Added Taxes (VAT) and they are going to sell it to their Republican base who hate taxes as a positive. Meanwhile, the Democratic base wants access to quality health care we have had for a century and our Medicare to remain strong. That is why social Democrats promote EXPANDED AND IMPROVED MEDICARE FOR ALL.
Wall Street Clinton/Obama neo-liberals always the far-right pols they are have already designed health policy that will POSE PROGRESSIVE----using the words like SINGLE-PAYER----instead of Expanded and Improved Medicare. What they do to use these same terms will be to create a public system and make it heavily funded by VAT---when social Democrats are simply going to pool existing Medicare, Medicaid, a dash of taxation on corporate health systems, with the ending of health system fraud and profiteering. No tax increase on citizens---simply controlling the corruption throughout the corporate system and allowing hospitals and health systems that exclude to pay taxes because---they are now FOR-PROFIT HEALTH INSTITUTIONS.
If Obamacare Is Overturned
March 28, 2012 By VATinfo
The Supreme Court may decide that individual mandates for insurance purchases oversteps the authority of the federal government. If Obamacare is overturned, there is a better alternative — single-payer in the shape of Dr. Zeke Emanuel’s plan for a dedicated VAT paying for vouchers to be used in an exchange. The VAT tax, dedicated to health insurance, would have precedent for the Supreme Court, e.g., the Social Security tax.
With a dedicated VAT tax, the citizenry would have a measure of health care costs vs. benefits that should work to restrain additional demands for more expensive tests and services. Corporations would be on an even footing in that the amount of medical insurance would no longer be a competitive benefit for employees.
Of great importance, the VAT burden would saddle imports equally with the burden of healthcare, and exports would not carry the burden. VAT is the border-adjustable tax for this era of globalization, i.e., added to imports and subtracted from exports. That is why it is used by all of our trading partners — to our competitive disadvantage.
Dr. Emanuel, Rahm’s brother, published a book detailing the plan, “Universal Healthcare Guaranteed.” Links to information about the Emanuel plan and VAT can be found at: http://wp.me/p18NCA-1o
Here you see the kabuki theater as two sets of global pols pretend they are disagreeing----when they are working towards the same goal----installing VAT. Now, Maryland Assembly is already moving towards this at the state level---they are raring to add more and more taxation on Maryland citizens.
Global pols are prepared to really confuse this social Democratic policy of simply expanding EXISTING MEDICARE with all the access to quality health care and equal access Americans have had for a century-----and they are calling a UNIVERSAL OR SINGLE-PAYER ----tied to VAT to sell VAT as a good tax. Remember, our US Medicare system is the finest in the world----in world history. It has been dismantled and defunded under Clinton/Bush/Obama----but it is still there----the Constitutional rights and War on Poverty are still there-----they are simply being RETOOLED FOR THE SECOND NEW DEAL.
Yesterday's articles used this term in comparing an Obama as a TRANSFORMATIONAL President on par with Reagan. They used the term SECOND NEW DEAL started with Reagan and moving forward with Obama. This means----ending the social Democratic NEW DEAL-----and replacing it with this very right-wing structure for addressing all social and public interest services and programs. Moving forward is replacing social Democratic structures with right-wing ideals of how society should look. It is not only right-leaning----IT IS FAR-RIGHT LEANING. This is why even Republican voters are shouting loudly---wanting to end OBAMACARE WHICH IS ROMNEYCARE WHICH WAS WRITTEN BY THE REPUBLICAN HERITAGE FOUNDATION.
This is why social Democrats like Bernie Sanders and Cindy Walsh will move away from Affordable Care Act and its VALUE-ADDED structure for maximizing corporate profit---and move back to our strong Federal Medicare----expanding it for all citizens paid for by simply ending corporate fraud and profiteering, pooling existing Medicare and Medicaid, and taxing health industry corporations. EASY PEASY FOLKS
Medicare: Emanuel Healthcare VAT Bridges Ryan & Obama
April 15, 2011 By VATinfo
On the editorial page, today’s NYTimes restates their opposition to potential future cost increases to Medicare recipients in Paul Ryan’s plan (“The Republican Medicare Reshuffle,” 04/15/11). Paul Krugman, too, decries the notion that unlimited benefits may not be paid for indefinitely without substantial additional contributions by recipients (“Who’s Serious Now?“). David Brooks in “Ultimate Spoiler Alert” endorses Ryan’s concept of using defined contributions, a de facto voucher system, for Medicare.
Dr. Ezekiel Emanuel, Director Bio-ethics at NIH has long proposed a plan which would bridge the divide. He has called for healthcare vouchers to be used in an exchange and paid for by a dedicated value added tax. This exchange should include Medicare as an option alongside private insurance, which would force the insurance companies to compete with the benchmark standard. Paying for healthcare with the VAT would ensure that healthcare consumers were aware of the costs and would force them to consider what demanding more benefits would mean to their pocketbooks.
The Ryan plan covers everyone over 55, today with the same benefits that retirees now enjoy. If, as OMB indicates it would cost another $7,000 per recipient in 2022, then the public could consider shouldering the increased burden via an increase in the VAT, which would be somewhat progressive since wealthier Americans consume disproportionately more than the less advantaged. And, those in the lowest brackets could be protected with Earned Income Tax Credits.
Corporations and labor should like this concept. It would remove the direct corporate burden of healthcare costs. VAT, subtracted from exports under GATT rules would make exports more competitive. The VAT would assure that imports carried an equal burden as domestic production and make U.S. labor and business more competitive at home.
Isn’t that a plan that both the President and Paul Ryan could support?
Obama and Clinton neo-liberals added expanded Medicaid to Affordable Care Act to pose progressive for the low-income citizens and did this while gutting Medicaid and Medicare spending of a $1trillion dollars in funding.
THIS IS WHAT REPUBLICANS CALL MAKING GOVERNMENT ACCOUNTABLE AND EFFICIENT....GUTTING A PROGRAM OF FUNDING TO ALLOW FOR MORE FRAUD, WASTE, AND MISAPPROPRIATION THROUGH BLOCK GRANTS AND VOUCHERS.
As global pols Obama did not intend to create strong health care access for the poor by expanding Medicaid----it was to increase the misappropriation of a Medicaid Trust that has had hundreds of billions of dollars lost to health industry fraud for these few decades----and to push the idea of needing this VALUE-ADDED TAX----VAT. Remember, the burden of these taxes are going to fall on the hospital providing the care and the patient----not the health insurance corporations or the larger health systems. This is all about soaking citizens with taxes in an health industry where payroll taxes have always covered this.
Use Healthcare to Sell the VAT, 01/09/11
January 9, 2011 By VATinfo
David Brooks concludes that “Overall, there is a strong likelihood that the current health care law will face an existential threat over the next five years. Each party should be preparing contingency plans.” (David Brooks “Buckle Up for Round 2,” The New York Times, 01/07/11)
The issues: the legality of individual mandates, the short-fall in voluntary membership in high-risk pools for the unemployed, the dumping of the poor and the sick from corporate and union plans onto the public insurance exchanges, the diminished competition from consolidation of medical providers plus the restriction on starting new hospitals, the high level of public and physician hostility.
Republicans appear to favor a shift to defined contribution plans with vouchers. It may come as a shock to some of them, but such a plan was suggested by none other than Rahm Emanuel’s brother, Ezekiel Emanuel, a physician and former head of bio-ethics at NIH.
Dr. Emanuel recognized that the burden of healthcare was huge for business and growing. His basic premise was that since everyone wants universal healthcare, everyone should be willing to pay for it. The concept was to remove the direct burden of healthcare from businesses and shift it to the population via a dedicated VAT.
This value added tax would pay for vouchers in the insurance exchange, which could (optionally) include Medicare as one of the insurance options. Emanuel wisely did not want the concept to live or die on the single-payer option, but including the Medicare option would enable the concept of single-payer to prove itself in competition with private plans.
Dr. Emanuel reasoned that those at the lowest income level could be subsidized for their VAT consumption cost through the EITC.
How to sell the VAT? Make it your healthcare ticket. Relieve businesses and unions of the direct burden. Shift to the VAT the direct private medical insurance expense plus shift the Medicare/Medicaid tax from payroll taxes to the VAT. Medicare and Medicaid amount to $453 billion and $290 billion, respectively, i.e., amounting to virtually one-half the 1.42 trillion budget deficit in 2009. If taxes must go up to end the huge deficit shortfall, at least the public would realize there is a direct benefit in healthcare for their VAT expense.
Consumers will then know that if they demand more health benefits, their VAT will rise, and they should show their willingness to support an increase. Being aware of the VAT percentage might provide a measure of self-limiting increases to our medical system expenses.
And, the VAT will force imports to share an equal burden of our healthcare cost, and that would help business compete within our borders. Since our high healthcare costs will now be subtracted from exports, our goods and services will be more competitive abroad.
The other side of health taxation in Affordable Care Act is this CADILLAC TAX. This tax was aimed right at quality health insurance plans tied to corporate health plans and labor union health plans both of which are the totality of private health plans. Global pols are taking corporations out of the health contribution cycle and moving Americans to paying all of these insurance expenses themselves even if they interject a combined benefit plan---it will only be PREVENTATIVE CARE.
This is yet another slap toward labor unions from Clinton to Obama as global Wall Street neo-liberals----and who is backing Hillary in Presidential elections? Many national labor union leaders while union members are going to Bernie Sanders.
The goal of the second NEW DEAL is to erase all of the public interest out of government so what has been quality, safe, equal access with a result of longer life spans for all-----is being dismantled and defunded----the CADILLAC tax being used as an excuse for everyone wanting to get rid of those quality plans.
Global pols want us to believe that corporations will willingly add to wages the difference in what they paid in health benefits.
To make it seem this is happening ----they are moving to corporate wellness programs that are preventative care only----and then will end those.
All the while Obama and Clinton neo-liberals are installing these corporate profit-making policies like the mandated insurance plan policy----they are posing progressive in saying this will fund the expanded Medicaid---which we see the goal is having a VAT against the same 95% to do that.
“Cadillac Tax” Will Hit 38 Percent of Employers in 2018
By John R. Graham Filed under Policy Updates on December 1, 2014
The “Cadillac tax” is the excise tax on high-value health plans, which goes into effect in 2018. If the value of health benefits exceeds $10,200 for an individual or $27,000 for a family, the excise will be taxed at 40 percent.
A new report from the American Health Policy Institute breaks down the effect on employers. As well as concluding that the Cadillac tax will hit 38 percent of employers in 2018, it estimates that the average employer-based policy will be subject to the tax by 2031.
There is no doubt the Cadillac tax will put an administrative burden on employers, and reduce the attractiveness of employer-based benefits. On the other hand, as the AHPI report notes, the Cadillac tax will cause employers to increase workers’ wages in exchange for reducing health benefits. Indeed, the Congressional Budget Office anticipates that 75 percent of the revenue due to the Cadillac tax will be from income and payroll taxes due to wage increases, and only 25 percent due to the Cadillac tax itself.
Notwithstanding the tax hike, shifting workers’ income from benefits to money improves their welfare, because they are free to spend their money on whatever they like. Also, the current exclusion of employer-based benefits from taxable income is a “tax expenditure” of over $785 billion over the next five years.
DOES ANYONE BELIEVE THAT CORPORATIONS ARE GOING TO RAISE WAGES TO COMPENSATE FOR LOST HEALTH BENEFITS---AS THE ABOVE IMPLIES?
That is not a subsidy, as some assert, because it only reduces people’s taxes. It doesn’t get paid out to people who do not pay taxes. However, it does create a hole in the Treasury.
Is it fair to give employees an unlimited tax break if they get health benefits from an employer, but not if they choose their own health insurance? And while a plurality of citizens probably accept that a certain value of health spending should be tax free, should it be unlimited?
Most conservatives reject this, and include some type of Cadillac tax in their reform plans. NCPA’s plan taxes employer based benefits in exchange for a universal, refundable tax credit that treats everyone the same.
These are the NEW DEAL and War on Poverty structures global far-right wing neo-liberals are trying to install. First, FDR New Deal health policy created a Federal agency and Federal laws stating that all hospitals must take all patients needing care in an emergency. This is why for a century anyone could go to any hospital and get care. Then the New Deal under FDR used the National Infrastructure funding after the Great Depression to build an entire national public health structure. This is from where our public hospitals, public health clinics, and all the public health safety standards of oversight and accountability came. This is the structure where FDA and Department of AG protect public health by overseeing food and PHARMA safety-----it is where clinical trials are required to make sure health PHARMA and procedures are safe before exposing the public to health risks. This is what created the Centers for Disease Control CDC across the entire nation in communities to guard and check against communicable disease. Lastly, it created the medical school structures tied to our public universities---like University of Maryland Medical System and its medical school.
ALL OF THIS IS THE ORIGINAL NEW DEAL PUBLIC HEALTH SOCIAL DEMOCRATIC POLICY THAT IS NOW BEING DISMANTLED UNDER AFFORDABLE CARE ACT.
The second New Deal will be one that places corporate profit in place of public interest by eliminating all of the above.
The American people received all of this by paying a reasonable 35-40% income tax-----payroll taxes----and whatever state and local tax that may be connected to health care.
Global pols under Affordable Care Act are removing all of this----planning to keep payroll taxes and adding a VAT where taxes will be heaviest at the bottom------you and me.
THIS IS HORRIBLE FOLKS! THE AMERICAN PEOPLE SHOULD BE ON THE STREETS SHOUTING BUT DEFINITELY GETTING RID OF ALL GLOBAL CORPORATE POLS.
I. Federal and State Tax Exclusions for ESI
Federal and state tax laws do not include the value of employer contributions for health insurance (or health benefits when paid directly by employers) in the income of employees. Employees often also can make their contributions towards the premium for ESI with income before it is taxed. This lowers the amount employees owe in income taxes, and lowers payroll taxes paid for Medicare and Social Security (collectively known as FICA, or the Federal Insurance Contributions Act taxes).1 The exclusions of employer and employee contributions from income and payroll taxes are the largest tax subsidy for private health insurance. We follow with some examples to show how the exclusions work and show how it ranges in value for families in different circumstances.
Affordable Care Act is indeed a huge taxing policy but none of the Affordable Care Act or the extra taxation is Democratic-----it all comes from Republican think tanks. Yet you will hear Republicans called this tax-and-spend Democrats ------because Obama ran as a Democrat-----serving right of center---they paint this as a Democratic taxing policy.
How the Affordable Care Act Will Affect Taxes
Thanks to the Affordable Care Act, the tax code is undergoing its biggest change in 20 years. The changes are likely to come as a big, money-pinching surprise to a lot of taxpayers.
H&R Block’s president and CEO Bill Cobb explains on MoneyBeat.
Full List of Obamacare Tax Hikes
Full List of Obamacare Tax Hikes: Listed by Size of Tax Hike
Complied by Americans for Tax Reform
WASHINGTON, DC -- Obamacare contains 20 new or higher taxes on American families and small businesses. Arranged by their respective sizes according to CBO scores, below is the total list of all $500 billion-plus in tax hikes (over the next ten years) in Obamacare, their effective dates, and where to find them in the bill.
$123 Billion: Surtax on Investment Income (Takes effect Jan. 2013): A new, 3.8 percent surtax on investment income earned in households making at least $250,000 ($200,000 single). This would result in the following top tax rates on investment income:
*Other unearned income includes (for surtax purposes) gross income from interest, annuities, royalties, net rents, and passive income in partnerships and Subchapter-S corporations. It does not include municipal bond interest or life insurance proceeds, since those do not add to gross income. It does not include active trade or business income, fair market value sales of ownership in pass-through entities, or distributions from retirement plans. The 3.8% surtax does not apply to non-resident aliens. (Bill: Reconciliation Act; Page: 87-93)
$86 Billion: Hike in Medicare Payroll Tax (Takes effect Jan. 2013): Current law and changes:
All Remaining Wages
Obamacare Tax Hike
Bill: PPACA, Reconciliation Act; Page: 2000-2003; 87-93
$65 Billion: Individual Mandate Excise Tax and Employer Mandate Tax (Both taxes take effect Jan. 2014):
Individual: Anyone not buying “qualifying” health insurance as defined by Obama-appointed HHS bureaucrats must pay an income surtax according to the higher of the following
Exemptions for religious objectors, undocumented immigrants, prisoners, those earning less than the poverty line, members of Indian tribes, and hardship cases (determined by HHS). Bill: PPACA; Page: 317-337
Employer: If an employer does not offer health coverage, and at least one employee qualifies for a health tax credit, the employer must pay an additional non-deductible tax of $2000 for all full-time employees. Applies to all employers with 50 or more employees. If any employee actually receives coverage through the exchange, the penalty on the employer for that employee rises to $3000. If the employer requires a waiting period to enroll in coverage of 30-60 days, there is a $400 tax per employee ($600 if the period is 60 days or longer). Bill: PPACA; Page: 345-346
(Combined score of individual and employer mandate tax penalty: $65 billion)
$60.1 Billion: Tax on Health Insurers (Takes effect Jan. 2014): Annual tax on the industry imposed relative to health insurance premiums collected that year. Phases in gradually until 2018. Fully-imposed on firms with $50 million in profits. Bill: PPACA; Page: 1,986-1,993
$32 Billion: Excise Tax on Comprehensive Health Insurance Plans (Takes effect Jan. 2018): Starting in 2018, new 40 percent excise tax on “Cadillac” health insurance plans ($10,200 single/$27,500 family). Higher threshold ($11,500 single/$29,450 family) for early retirees and high-risk professions. CPI +1 percentage point indexed. Bill: PPACA; Page: 1,941-1,956
$23.6 Billion: “Black liquor” tax hike (Took effect in 2010) This is a tax increase on a type of bio-fuel. Bill: Reconciliation Act; Page: 105
$22.2 Billion: Tax on Innovator Drug Companies (Took effect in 2010): $2.3 billion annual tax on the industry imposed relative to share of sales made that year. Bill: PPACA; Page: 1,971-1,980
$20 Billion: Tax on Medical Device Manufacturers (Takes effect Jan. 2013): Medical device manufacturers employ 360,000 people in 6000 plants across the country. This law imposes a new 2.3% excise tax. Exempts items retailing for <$100. Bill: PPACA; Page: 1,980-1,986
$15.2 Billion: High Medical Bills Tax (Takes effect Jan 1. 2013): Currently, those facing high medical expenses are allowed a deduction for medical expenses to the extent that those expenses exceed 7.5 percent of adjusted gross income (AGI). The new provision imposes a threshold of 10 percent of AGI. Waived for 65+ taxpayers in 2013-2016 only. Bill: PPACA; Page: 1,994-1,995
$13.2 Billion: Flexible Spending Account Cap – aka “Special Needs Kids Tax” (Takes effect Jan. 2013): Imposes cap on FSAs of $2500 (now unlimited). Indexed to inflation after 2013. There is one group of FSA owners for whom this new cap will be particularly cruel and onerous: parents of special needs children. There are thousands of families with special needs children in the United States, and many of them use FSAs to pay for special needs education. Tuition rates at one leading school that teaches special needs children in Washington, D.C. (National Child Research Center (link is external)) can easily exceed $14,000 per year. Under tax rules, FSA dollars can be used to pay for this type of special needs education. Bill: PPACA; Page: 2,388-2,389
$5 Billion: Medicine Cabinet Tax (Took effect Jan. 2011): Americans no longer able to use health savings account (HSA), flexible spending account (FSA), or health reimbursement (HRA) pre-tax dollars to purchase non-prescription, over-the-counter medicines (except insulin). Bill: PPACA; Page: 1,957-1,959
$4.5 Billion: Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D (Takes effect Jan. 2013) Bill: PPACA; Page: 1,994
$4.5 Billion: Codification of the “economic substance doctrine” (Took effect in 2010): This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed. Bill: Reconciliation Act; Page: 108-113
$2.7 Billion: Tax on Indoor Tanning Services (Took effect July 1, 2010): New 10 percent excise tax on Americans using indoor tanning salons. Bill: PPACA; Page: 2,397-2,399
$1.4 Billion: HSA Withdrawal Tax Hike (Took effect Jan. 2011): Increases additional tax on non-medical early withdrawals from an HSA from 10 to 20 percent, disadvantaging them relative to IRAs and other tax-advantaged accounts, which remain at 10 percent. Bill: PPACA; Page: 1,959
$0.6 Billion: $500,000 Annual Executive Compensation Limit for Health Insurance Executives (Takes effect Jan. 2013): Bill: PPACA; Page: 1,995-2,000
$0.4 Billion: Blue Cross/Blue Shield Tax Hike (Took effect in 2010): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services. Bill: PPACA; Page: 2,004
$ Negligible: Excise Tax on Charitable Hospitals (Took effect in 2010): $50,000 per hospital if they fail to meet new "community health assessment needs," "financial assistance," and "billing and collection" rules set by HHS. Bill: PPACA; Page: 1,961-1,971
$ Negligible: Employer Reporting of Insurance on W-2 (Took effect in Jan. 2012): Preamble to taxing health benefits on individual tax returns. Bill: PPACA; Page: 1,957