1. Health Care Tax Policy Just a lot of Buzz or Changes on the Horizon?

2. HCR: tax policies on the table 1. employer exclusion modification 2. new individual tax credit 3. new small business tax credit 4. elimination of HSA special tax treatment

3. The Big Kahuna Employer exclusion modification Why take it on? 1. Regressivity 2. Revenue (the big kahuna) 3. Transparency At the same time, dont undermine the ESI pillar.

4. Employer exclusion modification Tough Design Considerations: 1. move employers away from offers of comprehensive coverage 2. administrative costs/complexities to employers 3. administrative costs/complexities for IRS

5. Employer exclusion modification Tough Political Considerations: Will employers oppose hcr over this issue? How much money will a modification really raise? Is the opposition of this powerful lobby worth the money?

6. New Individual Tax Credit does not undermine public program coverage for lower income (other pillar of hcr) does not undermine esi significant size (income related) refundable, advanceable used for group-like coverage in a market with rate setting/rate review for quality coverage (w/ oop protections)

7. Health Savings Accounts Bad economic theory skin in the game Bad tax policy Money in tax free Money earned tax free Money out (medical expenses) tax free Bad health policy Poorly targets uninsured fragments market hurting sicker, older folks