Using Taxes to Reform Health Insurance: Pitfalls and Promises

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Few people realize that one of the nation's largest health programs runs through the tax system. Reformers of all stripes propose to modify current tax rules as part of larger programs to increase coverage and control costs. Is the current system working? Will tax-based reforms achieve their goals? Several of the nation's foremost experts on taxation and health policy address these questions in Using Taxes to Reform Health Insurance, a joint product of the Urban-Brookings Tax Policy Center and the American Tax Policy Institute. Led by respected economists Henry Aaron of the Brookings Institution and Leonard Burman of the Urban Institute, contributors examine the role taxes currently play, the likely effects of recently introduced health savings accounts, the challenges of administering major subsidies for health insurance through the tax system, and options for using the tax system to expand health insurance coverage. No taxpayer or consumer of health care services can afford to ignore these issues.

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Editorial Reviews

From the Publisher

"The volume provides an excellent, timely overview of the problem and how tax restructuring could yield improved performance from the health care system." — CHOICE

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Product Details

  • ISBN-13: 9780815701255
  • Publisher: Brookings Institution Press and Urban Institute
  • Publication date: 12/1/2008
  • Pages: 300
  • Product dimensions: 5.90 (w) x 8.90 (h) x 1.10 (d)

Meet the Author

Henry J. Aaron is a senior fellow in Economic Studies at the Brookings Institution, where he holds the Bruce and Virginia MacLaury Chair. Among his many books are Can We Say No? The Challenge of Rationing Health Care, with William B. Schwartz and Melissa Cox (Brookings, 2006), and Reforming Medicare: Options,Tradeoffs, and Opportunities, written with Jeanne Lambrew (Brookings, 2008). Leonard E. Burman is director of the Urban-Brookings Tax Policy Center and a senior fellow at the Urban Institute. He is the author of The Labyrinth of Capital Gains Tax Policy: A Guide for the Perplexed (Brookings, 1999) and coeditor with Henry Aaron and Eugene Steuerle of Taxing Capital Income (Urban Institute, 2007).

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Table of Contents

1 Introduction Henry J. Aaron Aaron, Henry J. Leonard E. Burman Burman, Leonard E. 1

2 Tax policy and the history of the health insurance industry Robert B. Helms Helms, Robert B. 13

3 The tax code, employer-sponsored insurance, and the distribution of tax subsidies Leonard E. Burman Burman, Leonard E. Bowen Garrett Garrett, Bowen Surachai Khitatrakun Khitatrakun, Surachai 36

4 Health savings accounts : recent trends and potential effects on coverage and health insurance markets Lisa Clemans-Cope Clemans-Cope, Lisa 67

5 What's in a name? : are health savings accounts really health savings accounts? Henry J. Aaron Aaron, Henry J. Patrick Healy Healy, Patrick Surachai Khitatrakun Khitatrakun, Surachai 92

6 Tax subsidies for out-of-pocket health care costs Jessica Vistnes Vistnes, Jessica William Jack Jack, William Arik Levinson Levinson, Arik 119

7 Administrative issues : challenges of the current system Mary B. H. Hevener Hevener, Mary B. H. Charles K. "Chip" Kerby III Kerby, Charles K. "Chip", III 147

8 The challenges of implementing health reform through the tax system Janet Holtzblatt Holtzblatt, Janet 171

9 Reforming the tax treatment of health care : right ways and wrong ways Jason Furman Furman, Jason 211

10 Simple humans, complex insurance, subtle subsidies Jeffrey Liebman Liebman, Jeffrey Richard Zeckhauser Zeckhauser, Richard 230

11 Taxes and health insurance Peter Orszag Orszag, Peter 263

Contributors 271

Index 273

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