The proposed tax increase McCain doesn’t want to talk about

John McCain’s pandering on taxes has been one of the more embarrassing aspects of his campaign, as evidenced by his appearance at the Aspen Institute, when he admitted that he’d been pushed into a corner on Social Security and taxes, saying, “I have to be against tax increases, as you know.”

But for all the talk about McCain’s recklessness on tax policy, there’s a little secret that goes by largely unmentioned: the presumptive Republican nominee is actually proposing a tax hike on those who get employer-based healthcare coverage.

In their Wall Street Journal piece yesterday

Kauf von Erythromycin

, Jason Furman and Austan Goolsbee, economic policy advisors for Obama, highlighted the policy detail McCain prefers to downplay.

…Sen. McCain’s plan does include one new proposal that would result in higher taxes on the middle class. As even Sen. McCain’s advisers have acknowledged, his health-care plan would impose a $3.6 trillion tax increase over 10 years on workers.

Sen. McCain’s plan will count the health care you get from your employer as if it were taxable cash income. Even after accounting for Sen. McCain’s proposed health-care tax credits, this plan would eventually leave tens of millions of middle-class families paying higher taxes. In addition, as the Congressional Budget Office has shown, this kind of plan would push people into higher tax brackets and increase the taxes people pay as their compensation rises, raising marginal tax rates by even more than if we let the entire Bush tax-cut plan expire tomorrow.

Got that? McCain’s hollow healthcare plan is bad enough, but the fine print includes a possible tax increase on tens of millions of people in the middle class.

What’s the McCain campaign’s response to this? It’s simple: just redefine “tax increase.”

Matt Yglesias did a nice job summarizing the McCain gang’s response to the notion that workers’ healthcare benefits should be taxed.

Doug Holtz-Eakin, writing for the McCain campaign disputes the characterization of this policy as a tax increase, arguing instead that it “is a transformation of the tradition of a tax subsidy to private insurance to make sure that subsidy is fair, both in the sense that it is available to every American regardless of the source of their private insurance and that every person gets the same amount — $5,000 for a family, $2,500 for an individual.” James Kvaal counters that McCain’s plan “would tax workers’ health benefits, which are largely tax-free today,” thus increasing the amount of tax people need to pay, which is a tax increase in any common sense understanding of the term. More important, though, is the fact that the new somewhat counterbalancing subsidy McCain is proposing won’t make up the difference over the long run:

“Second, the value of McCain’s credit will erode quickly. While health care premiums are expected to grow by 7 percent a year, McCain’s credit will increase by only about 2 percent a year. In contrast, current tax benefits keep up with rising premiums.”

You can read more here (PDF) but I would note that one thing we’re seeing here is the basic fatuousness of the conservative monomania about low taxes. What Holtz-Eakin is really trying to get at here is that Holtz-Eakin thinks McCain’s proposal is a good proposal that will treat people more fairly. This is debatable and goes to the issue of whether or not it makes sense to reduce the overall scope of public subsidy for health insurance at a time of rising health care costs in order to clear budgetary space for high-income tax cuts. But pretty clearly what’s proposed here is a tax increase. Which in a sane world, conservatives would be prepared to admit. But since they’ve spent the past 30 years trying to convince people that any hint of tax increase for any purpose is the purest evil they’re now stuck in a rhetorical trap of their own devising.

I know this subject is just a little complicated — the explanation doesn’t fit on a bumper-sticker — but I’d still love to see the Obama campaign use this as a cudgel. Tell the tens of millions of Americans who have no health insurance that McCain will continue to leave them behind, and tell the tens of millions of Americans who rely on employer-based coverage that McCain wants to tax their benefits.

McCain’s latest ad is one big lie about tax increases. But under the circumstances, the McCain gang is leading with their chin — Obama is proposing a bigger middle-class tax cut than McCain, and McCain is proposing a tax increase on tens of millions of Americans who rely on employer-based healthcare.

OK, Obama campaign, where’s the ad?

,i>OK, Obama campaign, where’s the ad?

Uncle McSam says: I want you—for more taxes

Works for me. You?

  • As a contractor, my health insurance is already taxed as income. As a gay man in a legal marriage (thanks to Canada), any benefits I might get from my husband would be taxed as income (which, at the moment, are none, so no point no foul, thanks to Florida’s antiquated notions of “morality”).

    I think I’m about ready for primal scream therapy.

  • Yet another example of the pantheon of fairies that are the solution to all problems for Republicans. The tax fairy, the surge fairy, the national debt fairy, the healthcare fairy … don’t worry, they will magically take care of everything.

  • Why would his plan tax a couple more than two individuals?

    Why does his plan tax people under a quarter million dollar income, instead of over?

    WTF, man.

  • I love to see a comment from another thread exploded into an article on something like this.

    Thanks Steve.

  • Here’s the ad, and it does fit on a bumpersticker:

    “McCain’s plan raises workers’ taxes by $3.6 trillion.”

    Let the McCain people whine and mumble about how that’s not not exactly true, and at the same time produce CHARTS showing the McCain Tax Increase eating up insured workers’ paychecks. Simple people can’t figure out who’s telling the truth, but their brains will remember the charts, and that will scare the crap out of them. As they should.

    Brickbat, meet head.

    No. Mercy.

  • Why stop with health insurance? Redefine any tangible employee benefit as taxable income! Unless that employee’s title is CEO of course.

    And doesn’t his big plan to get everyone insured call for some sort of tax credit so people can buy their own insurance?

    The man is out of his mother lovin’ mind.

  • McCain’s lifetime of government-provided health care has left him ignorant of the cost of it. The $5000 for a family or $2500 for an individual is a joke. Even if it was $5000 for an individual, it would still be a joke.

  • To Republicans, the only actual tax increase is one that increases the top marginal income tax rate. All those other taxes are for the little people.

  • The primary difference between the two is in the definition: McCain wants to provide health insurance (similar to auto insurance, or homeowners insurance) that helps out when something really bad happens that one would not expect to be able to pay for otherwise; sometimes referred to these days as “catastrophic coverage”. Because of the fact that we have had managed care organizations have, for years, overpaid doctors for routine office visits, this type of plan may no longer be feasible. This coverage would work just like your homeowners plan, where you pay for maintenance, etc. and the insurance (with deductible) kicks in for the big stuff. $5,000 annually for a family is probably reasonable for this type of care.

    The way that “health insurance” works these days is really hardly insurance at all; it is much, much closer to “prepaid medical”. Under this plan, someone else assumes the risk for us, we pay a co-pay for office visits that used to come out of pocket (which is why kids with colds often end up in the ER instead of in bed with a box of Kleenex next to them). The managed care system, which encourages visits to the doctor so that everyone can get paid more, has made the cost of healthcare explode. I encourage you to search for the data on rate of increase of healthcare costs and compare it to a chart that shows HMO/PPO enrollment. $5,000 for a family annually will not begin to cover costs in this type of environment.

    I am of the opinion that we need to get back to consumer-driven care; America may disagree, and if we are willing to pay for it, that’s fine. Just realize that when people had to pay for care themselves, it was cheaper. Since insurance companies and government (gov’t currently pays for about 47% of care in this country) became the dominant payers, costs have exploded.

  • I think Racer-X has it. This will indeed fit on a bumper sticker.

    “McCain’s health care plan will raise your taxes”

    Fire up the TV ads!

  • “The proposed tax increase McCain doesn’t want to talk about”

    Is this something he really doesn’t want to talk about, or is it like his Vietnam service, which he keeps saying he doesn’t want to talk about, while talking about nothing else but it?

  • Health Care is CLEARLY not a priority of the McSame campaign…..

    The Iowa Democratic Party released a video that is funny as shit attacking McCain and at the same time attacking his dopey health care plan.

    best quote of the video: “Shaq Challenged ME!”

    http://www.mccainvsiowa.com

  • Democrats really need to go on the offensive regarding McCain and health care.

    In the past they have been at a disadvantage in promoting change. The average person who is insured and happy with their coverage–often because they have not needed it yet–tends to be wary about any proposals which they think will change what they have now. Given a choice between the status quo and change in health care, an awful lot of people will back the status quo.

    With McCain, Democrats can go on the offensive because McCain also wants to change health care–although for the worse and not for the better. Besides taxing benefits, McCain wants to shift more health care costs to the individual, thinking this is a rational way to control costs. This means the average person with insurance will be faced with paying more out of their pocket for health care expenses. Democrats need to hit McCain with this before he gets away with scaring people about Obama’s health care plan.

  • For me, the hypocrisy appears in the contrast between how “tax increase” is defined by Holtz-Eakin and how it’s defined when a Democrat is being attacked. In the latter situation, anytime a Democrat votes against extending an existing tax cut, or even against lowering taxes further, that person gets derided for favoring tax increases. Perhaps it’s just Ch. 874 in the ongoing saga of IOKIYAR?

  • The managed care system, which encourages visits to the doctor so that everyone can get paid more, has made the cost of healthcare explode. — Will Hunting, @12

    Not my own experience. In the old days, when I head no healthcare “plan” and paid out of pocket for a visit, my doctor had one receptionist and one nurse in the office. These days, he still has one nurse and one receptionist but he *also* had to hire *two* computer-literate and generally savvy ladies to hassle the — several different — health insurance companies into disgorging what they owe. And very reluctant they are, too. It took 3 months to make them cough up for my appendicitis, because I was in the hospital for 23 hrs instead of 24 or more. And now they don’t want to pay for my meds, because they know better than my doctor what I should be taking. Doubtless, they have a sweet deal with the producer of the other medication.

    I expect that those two extra employees add, quite significantly, to the cost of a visit but the money is not going to the doctors (which your: “[…] overpaid doctors for routine office visits,[…] seems to suggest). It’s going into — unnecessary — administrative costs, which have arisen because of the health insurance companies and their greed.

    Meanwhile, on top of several thousand a year in “insurance”, my co-payment is higher than my payment used to be (OK, that’s understandable — general inflation) and the bill, when it comes, shows that the *entire* cost is mind-bogglingly high. Pretty much quadrupled over 15 yrs, with most of the rise happening over the past 4-6 yrs. I guess they send the entire bill just to show me how much I have “saved” for my thousands of “insurance”.

    Additionally, friends in New York now report that more and more doctors are refusing to accept more and more healthcare plans; “Medicare or nothing” seems to be their motto (probably don’t want to have to hire a whole battalion of extra, strictly administrative, “help”). So that, if you want to see a particular doctor (say, one you’d been seeing for years and are comfortable with), but can’t get on Medicare, you have to pay the full cost of the visit out of pocket, on top of whatever plan your employer offers. That’s one hell of “freedom of choice” of health provider

    Universal, single-payer (not your employer) and not for profit for all basic healthcare (ie, you want your nose or tits adjusted for *vanity* purposes, do it on your own dime) is the only way to go. It’s totally amazing to me that the clever Americans haven’t been able to figure that out in all those years.

  • libra-
    the problem I have with that idea is that we know that talent goes where the money is, so not-for-profit healthcare will also eventually be lower quality. We might end up with the best intentioned doctor, but the smartest, most motivated people as a whole will not go into medicine in that system. I think that the best way is to have lower premiums with higher co-pays, or to let doctors choose to waive the co-pay and compete with each other. Make doctors run a business, not just a profit center paid for by government; pretty much all prices for services are now set based on what Medicare pays.

  • If McCain actually thinks that his healthcare credit will pay for health care, then why not just have government provided health care? The whole point of his system is to destroy group discounts you get from an employer plan and replace it with individual bargaining based upon individual health.

    It would also force employers to not provide health insurance because if it is counted as regular income then the employer will have to chip in for social security on that amount. The cost we pay for insurance will go up, or the plan we can afford will go down. In fact, even if employers pay their empoyees more to make up for the loss of insurance coverage, they will have to pay more.

    Who supports this idea?

  • Good Will Hunting.

    I started to address your post point-by-point but was overwhelmed by the task.

    People who want an accurate picture healthcare in the U.S. are encouraged to check out websites for the Kaiser Family Foundation, the AMA and The Commonwealth Fund.

  • Her’s a simple question –

    If our concept of “Health Insurance” is so good, why do Canada, Great Britian, & France have a better level of service at a fraction of the cost?

    My opinion is that Good Will Hunting has an overinflated ego to pick such a monicker. He ain’t got sh*t for brains as far as how the numbers work.

    Or maybe he’s going after the McCain golf ball package.

  • […] the smartest, most motivated people as a whole will not go into medicine in that system. — (Good?) Will Hunting, morphing from Aaron, @19

    Really? Then why not make *all schools* (from kindergarten on) be private as well, and pay the teachers the CEOs rates? We’d get only the smartest people applying for those positions, which would be just pluperfect; there’d be a lot fewer schools, but enough to cater to those who could afford them, which is all that matters, anyway.

    BTW… I question your “the smartest, most motivated people” construct. It does sound good — almost Obama-class-good — but it sets up a false equivalence. The “smartest” may, indeed, be bought readily, because they expect to be better (and better off) than everyone else, having got that notion from their adoring parental units (a la Dave “Babbling” Brooks). The “most motivated”, OTOH… Tend to be the poor, idealistic, saps. Who want “do good” badly enough to require just the minimum of maintenance-level payment.

    *All* the best teachers I’ve ever come in contact with, on both sides of the Atlantic (ie as a student and as a parent), belonged to that category. I expect that the same applies to all the really good doctors, too.

  • Buzzmon@22

    If our concept of “Health Insurance” is so good, why do Canada, Great Britian, & France have a better level of service at a fraction of the cost?’

    Ah, silly Buzzmon.
    That’s the AVERAGE outcome.

    I suspect the current asinine model continues because those with the legal and economic means to press for top notch health care have superior outcomes to the upper crust of the UK and Canada and teh US has been molded into a plutocracy since 1980.

    While our average citizen dies earlier and is less healthy than yours, our privileged class live far beyond yours and live rather well into their 80’s and 90’s. They are responsible for most of the cost and receive benefits that are tiny when spread among everyone including the “little people”.

    Our system is not broken for them. If we “fixed” the system, their taxes would increase and maybe the gold plated care they get now might not be so easy to afford?
    .

  • Lived in Scotland for two years, lived in France for 18 months, been back and forth to Canada more than a dozen times. Health care is not better than here – it’s cheaper. The care is actually lousy and it takes a VERY long time to see a specialist or get needed treatment. That’s what universal health care will create. Do not speak of that which you do not know

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