• Lead to better personal health for all Americans, with emphasis on self-care and prevention first, and ensure access to appropriate medical care when needed;
• Simplify administration and reduce non-value added administrative processes; and
• Align all stakeholders—physician, payor, patient, and family—with the best interests of the individual patient.

SHPS Impact of Group Health Tax Exclusion Worksheet
Use this Excel spreadsheet to calculate the impact of healthcare reform financing proposals on the paychecks of your employees. SHPS has put together an application that allows you to model different proposals to tax group health benefits. The application allows you to input salary, W4 status, pre-tax health benefits, 401K pre-tax benefits, and post-tax benefits. The tool then calculates how the employee's taxes would change under several different scenarios, as well as calculating the additional FICA that would be paid by the employer. This spreadsheet has not been copyrighted so please share it as you feel appropriate.

  Update on Healthcare Reform
Published by SHPS
October 21, 2009

This document is a copy of the presentation given to SHPS clients on October 21, 2009. It provides updated information regarding the proposed options from both the Senate and the House for healthcare reform.

  Update on Healthcare Reform
Published by SHPS
June 3, 2009

This document is a copy of the presentation given to SHPS clients on June 3, 2009. It provides updated information regarding the proposed options for financing healthcare reform and their impact on spending accounts.

  Joint Committee on Taxation Estimated Revenue Effects of Certain Proposals
Published by the Joint Committee on Taxation
June 2, 2009

Congress has been actively investigating different options to pay for the cost of obtaining coverage for 48 million uninsured Americans. In this document, the Joint Committee on Taxation of the U.S. Congress analyzes several different options for raising money to pay for healthcare reform. Current estimates are somewhere on the order of $2 trillion over 10 years, and President Obama has requested that healthcare reform be "deficit neutral." SHPS finds their analysis to be quite stark. There is no simple way to finance healthcare reform without placing a cap on the employer tax exclusion. Proposals that would impact high income individuals only (e.g. AGI in excess of $100,000 for single filers, and $200,000 for joint filers) will cover only eight percent of the revenue needed. Therefore, some form of cap or percentage limit on the group health tax exclusion seems likely. On June 11, SHPS had direct conversations with Senate and Congressional staff members who confirmed this conclusion.

  Letter from the President to Senator Edward M. Kennedy and Senator Max Baucus
Published by Office of the Press Secretary, The White House
June 2, 2009

This document is President Obama's letter to Senators Kennedy and Baucus on healthcare reform. A key provision of the letter demands that healthcare reform be deficit neutral, meaning any new spending is offset by new revenue, and that a final bill should reach Obama's desk by October. The document does not take a strong position on the tax exclusion for employer-sponsored health benefits.

  Limiting the Tax Exclusion for Employer-Sponsored Insurance Can Help Pay for Health Reform
Published by Center on Budget and Policy Priorities
June 2, 2009

This article by Paul N. Van de Water provides a concise description of why some policy makers advocate limiting the tax exclusion for employer-sponsored health insurance. Although some of Van de Water's arguments have theoretical merit, SHPS believes the key flaw is his assumption that a limit on the tax exclusion can be effectively designed to minimize financial impact to middle-class workers, and can be easy to administer. His analysis of FSA usage has no basis in fact, and neglects the role that FSAs play in the management of personal health. He wrongly assumes FSAs drive the inappropriate use of high-cost healthcare when, in fact, FSAs drive the cost-efficient use of preventive and primary care. To Van de Water's credit, he does accurately predict enormous political risk if the flawed but effective employer group health insurance sector is dismantled without having a robust alternative immediately in place.

  FSAs At A Glance
Published by SHPS
June 1, 2009

This document provides important information about FSAs to dispel erroneous points of view that are currently circulating in Congress. It contains key FSA data such as median income of FSA users, average health FSA contribution, and other demographic information.

  Impact of FSA Regulatory Changes on Middle-Class American Families
Published by SHPS
June 1, 2009

This document provides an analysis of how proposed changes to the tax exclusion for employer-sponsored health benefits, such as eliminating the FSA or putting a ceiling on the tax exclusion might impact employees. These cases were taken from actual employees, and are very reflective of how American workers use group benefits today. In Case 3, note the significant impact to a family with group health coverage and a high level of contribution to an FSA. We recommend our clients develop a similar type of analysis appropriate for their employees. Because these examples show the impact on the employee’s paycheck, the impact of the proposed legislation can be most clearly understood.

  Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options Senate
Published by Senate Finance Committee
May 20, 2009

The Senate Finance Committee released this white paper to the public disclosing several different options for financing healthcare reform. In this document, the employer group health tax exclusion is explicitly singled out as the largest potential source of income. The Senate Finance Committee requested written comments from the public by May 26th. The document also discusses the possible elimination of the health flexible spending account (FSA).