Reforming the Tax Treatment of Health Care to Achieve Universal Coverage

A growing number of legislators are eyeing the tax code as a way of alleviating the nation's uninsured problem. Today's tax treatment of health insurance provides more than $120 billion in tax breaks to help working families obtain health coverage. However, economist Stuart M. Butler argues that the system is neither a universally available nor equitable way to provide health care benefits. For example, millions of low-income workers and people who work in firms that do not offer health coverage do not benefit from today's tax code policy, and people with high incomes and generous health coverage benefit the most. Butler proposes a new insurance coverage model that would make refundable tax credits available to households as a substitute for the historical tax treatment of health benefits. He views this as a way of achieving near-universal health coverage for working families, including self-employed people. At the same time, the plan would grant funds to states to expand health insurance coverage to more residents and would make insurance more affordable in the private market.