1. The Tax Expenditure for Health: Update for 2007 John Sheils April 29, 2008

2. © Ingenix, Inc. 1 Projection of Federal and State Tax Expenditures for Health Benefits: 2007 Source: The Lewin Group estimates using the Health Benefits Simulation Model (HBSM). Notes: OASDI is Old Age, Survivors, and Disability Insurance, HI is Hospital Insurance Federal and StateFederal State $25.4 billion 10.3% Federal $220.3 billion 89.7% Social Security OASDI Tax $64.3 billion 29.2% 7.8% 3.9% 0.7% 1.9% 4.4% 52.1% Income Tax Health Benefits Exclusion $114.8 billion Medicare HI $17.2 billion Self Employed Deduction $4.1 billion Health Reimbursement Accounts $1.8 billion Out-of-Pocket Deduction $8.5 billion Retiree Exclusion $9.6 billion Total Tax Expenditures = $245.7 billionTotal Federal Tax Expenditures = $220.3 billion

3. © Ingenix, Inc. 2 Distribution of Federal Health Benefits Tax Expenditures by Family Income: 2007 $150,000 or more $29.1 billion 13.2% 16.7% 18.2% 22.9% 9.5% 9.7% 6.1% 3.2% 1.5% $100,000 - $149,999 $36.9 billion $75,000 - $99,999 $40.1 billion $50,000 - $74,999 $50.5 billion $40,000 0 $49,999 $21.0 billion $30,000 – 39,999 $19.1 billion $20,000 – 29,999 $13.4 billion $10,000 - $19,999 $7.0 billion $150,000 or more $3.2 billion Total Federal Tax Expenditures = $220.3 billion Source: The Lewin Group estimates using the Health Benefits Simulation Model (HBSM).

4. © Ingenix, Inc. 3 Average Federal Health Benefits Tax Expenditure by Family Income Level: 2007 Source: The Lewin Group estimates using the Health Benefits Simulation Model (HBSM). Note: The average per family is $1,748

5. © Ingenix, Inc. 4 Average After-Tax Savings in Health Spending for Families under President’s Proposal a/ Family Income <$10.000$10,000- $19,999 $20,000- $29,999 $30,000- $39,999 $40,000- $49,999 $50,000- $74,999 $75,000- $99.999 $100,000- $149,999 $150,000 and over Net Savings to Families All Families a/ Estimates are for families with a family head under age 65 and include changes in premiums, out-of-pocket spending, taxes and wages under the proposal.

6. © Ingenix, Inc. 5 Change in Federal Deficit under President Bush’s Health Care Tax Deduction Proposal: 2009 – 2018 (billions) 2009201020112012201320142015201620172018 Source: The Lewin Group estimates using the Health Benefits Simulation Model (HBSM). Increase in Deficit Reduction in Deficit