WASHINGTON, Jan. 25, 2007
Will Bush Health Plan Save You Money?
Analysis: It Would Help Many In Middle Class, But Not Those In Low Brackets Who Already Pay No Income Tax
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Play CBS Video Video Bush On Health Care President Bush proposed initiatives to help more Americans afford health insurance and to help states cover the uninsured.
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Video Obama On Health Care CBS News RAW: At a news conference for Families USA, Sen. Barack Obama, D-Ill., calls for universal health care.
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(AP / CBS)
If an employer-provided plan covers you alone, the policy costs just under $2,500 on average, still low enough for a tax cut.
The administration says its proposal would enable more Americans to afford health insurance, reducing the ranks of the uninsured — now estimated at 46.6 million — by 5 percent to 10 percent.
The president hit the road Thursday to sell his health care plan, talking it up at a conference in Lee's Summit, Mo. But it has received a cold response from key Democrats in Congress.
The plan would do two things: For the first time, the cost of an insurance policy would be treated as taxable income. The cost includes both the employer's and the employee's payments. The result is that workers' taxable wages would shoot up dramatically.
But, then, the president calls for a standard tax deduction for those who buy health insurance — $15,000 for family coverage and $7,500 for individual coverage. So, the key to getting a tax cut will be to keep the cost of the policy below the size of the new deduction.
The result of the proposed change would be that, initially, about 80 percent of workers who get insurance through their jobs would be in the camp that gets a tax cut. About 20 percent would see a tax increase.
About 160 million people get health coverage through their employers.
A smaller group of Americans, about 17.8 million, buy health insurance on their own because their job doesn't provide it or they can't afford the coverage their employer offers. Almost all of these people would experience a substantial tax cut, because they don't have a boss fronting the cost of their insurance on a tax-free basis. They pay for it themselves and get little tax help unless they spend at least 7.5 percent of their adjusted gross income on health care.
Karen Davis, president of the Commonwealth Fund, said the people who buy insurance on their own are typically baby boomers. Of the 12 million adults in the individual market, 40 percent of them make more than $50,000 a year.
They would save, on average, about $2,500 when buying individual coverage and $5,000 on family coverage, she said.
"I definitely think it is fiscal relief" for those in the individual market, Davis said.
That relief is much more mixed when it comes to people who get health insurance through their work, she said.
Just how much someone pays or saves depends upon which income tax bracket they're in. The administration projects that the greatest benefit would go to the middle class.
The wealthy tend to have the most expensive policies, and many of them can expect to pay higher taxes. Meanwhile, the poor generally don't pay any income tax, so the help they get would be limited to lower payroll taxes.
The administration has referred to health insurance policies exceeding $15,000 for a family or $7,500 for an individual as gold-plated, but many disagree with that assessment.
"Not all these policies are gold-plated. What you get depends on where you live, where you work and what the cost of insurance is in that area," said Diane Rowland, executive vice president of the Kaiser Family Foundation.
Workers in established manufacturing industries, such as the auto and steel industry, tend to have generous health insurance benefits, so they could see their taxes go up if they stick with their current policy. So could many government workers.
Also, large firms tend to have better, and more expensive, policies than do small businesses. Davis said large businesses tend to treat the great majority of employees equally.
"Typically, the person working in the mail room has the same health coverage as the person working as an executive," Davis said.
But John Goodman, president and CEO of the National Center for Policy Analysis, disagreed. He said executives at large corporations often get extra benefits on top of the insurance that everyone else at the company gets. They'll get annual checkups and undergo screenings at the most renowned medical facilities such as the Mayo Clinic, or, in his home town of Dallas, the Cooper Clinic. It makes little sense for the government to subsidize such health insurance plans, he said.
"It's not unusual at all to find the guys at the top with the most lavish plan," Goodman said.
While more than 100 million people would get a tax break, the administration estimates, more than 55 percent of the uninsured — about 25 million people — have such low incomes that they pay no income taxes, Davis said. So the tax changes would not make insurance any more affordable for them, she said.
The president's plan would not kick in until 2009. Over the years, the standard deduction would increase at the rate of overall inflation. But some tax analysts warn that the deduction would still lose value as a result.
That's because health insurance premiums have been going up much more quickly than inflation, so, eventually, more taxpayers will fall into that camp whose health insurance cost more than the deductible. When that happens, they have two choices: Pay more taxes or select more basic, less expensive insurance plans.
The administration says it believes that people will seek out more basic coverage to avoid tax increases.
"We think that will bring down national health spending," said Katherine Baicker, who serves on the president's council of economic advisers.
Some analysts also worry that more small businesses will drop coverage if they know their workers can get coverage on the individual market, thanks to the new tax breaks for people buying insurance on their own.
Coverage in the individual market is generally cheaper than coverage in the group market, but many Americans, particularly those with pre-existing health conditions, will find it difficult getting a company to sell them a policy, said Len Burman of the Tax Policy Center, a joint program run by the Urban Institute and the Brookings Institution.
"For many, the non-group market doesn't work well," Burman said. "It works fine for people who are healthy. It just doesn't work well for people who are sick."
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Best-selling author Mitch Albom on his first nonfiction work since "Tuesdays with Morrie."
As to the low-income people using "medical coupons" (whatever that is?), even someone working at a minimum-wage full-time job has income that puts them over the limit to qualify for health care assistance in most states. Where do most have to go for their care? The Emergency Room, which results in hospitals having to eat the costs because the people can't pay the bills, which then drives up the cost of health care for everyone. These "tax breaks" simply are not going to help those who really need the help, they're only going to put a few more dollars in the pockets of those who want another $5 Starbucks coffee while they drive their 9 passenger SUV, alone, to work.
How can we fund our soon to be bankrupt social contract with fewer wages eligible for taxation?
We're all pawns in King George's game of chess.
My contribution to my health, dental and prescription insurance was $60.00/week. Our 3 tier coverage came from ONE and only ONE insurer -- there were no other choices -- there was no competition. That was the fault of our employer.
Many of us were single and living solely on one income. One does not have to be John Nash to calculate the inequity.
I'm definitely not rich. Yet I'm neither middle class nor poor; I'm teetering somewhere in between. I pay taxes. Some weeks my cat eats better than I because I pay for my prescriptions in lieu of buying food. I joke that I haven't had to shop the pet food aisle for myself -- just the cat.
I'd like to her King George's comments about my, and I'm sure thousands of others, situation. I doubt he could even begin to put himself in my shoes.