To understand what today’s news of the House voting to repeal and not quite replace Obamacare really means, let’s think back to World War II for a moment.
The federal government was worried about war-time inflation, and so proposed wage and price controls. Labor unions objected. To satisfy workers, the National War Labor Board agreed to exempt employer-provided health care from both wage controls and income tax.
That tax benefit was supposed to be temporary. Nearly 75 years is a lot of “temporary.”
The tax break for employer-provided health care is worth more the higher one’s income tax rate, which means it is worth nothing at all to the bottom half of the population, which doesn’t have a positive income tax rate.
The break has led to a world in which the well-paid and well-employed are well-insured, and the marginally employed — lower-pay workers, part-time and temp workers, the rest of the roughly 30 million Americans under the age of 65 in this category — still have no health insurance.
Flash forward to today. The non-taxation of employer-provided health care is a tax break worth $250 billion a year, nearly $3 trillion over a 10-year period, to the top half. Were we to repeal this tax break, alone, America could more than pay to insure all uninsured Americans with the resulting revenues.
What does this have to do with today’s news?
Today, the House, aided and abetted by President Trump, did not vote to change, repeal or limit the tax break for health insurance for the upper half of Americans, in order to continue Obamacare’s promise to bring health care to all.
Instead, the House, aided and abetted by President Trump, voted to cut taxes on the upper half in order to seriously gut the promise of universal health care.
As it happens, the taxes cut were only a third of the value of the tax break that was not changed (roughly $900 billion compared to $2.7 trillion).
In sum, the top earners get to keep their full $250 billion a year of health care tax breaks, the thing that was supposed to be temporary.
The people at the top also get back the $80 billion in taxes they were paying to help the people at the bottom of the income scale get some insurance, the thing that was supposed to be permanent. (Among these taxes are increases in Medicare charges and a 3.8 percent additional tax on investment income, both being collected exclusively from individuals earning $200,000 or families earning $250,000 or more annually.)
These are taxpaying households that have benefited and continue to benefit significantly from tax-free healthcare.
That only sounds inconsistent, until one sees who wins every time: the top.
The fundamental things apply.
And so now, looking to the future, death may be coming sooner to some after today’s news, as 24 million more might join the rolls of the uninsured. But it seems like Americans can all count on this fundamental thing applying: Trump, Ryan and like-minded Republicans everywhere will work their hardest to get rid of death taxes, so that the heirs of billionaires will never, ever, have to worry about paying taxes again.
Health and taxes may be forever joined at the hip for the most fortunate Americans, and soon the tax man won’t even be calling to disturb the billionaires’ blissful peace.