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Int J Health Care Finance Econ. 2011 Jun;11(2):101-13. doi: 10.1007/s10754-011-9090-x. Epub 2011 Apr 3.

The welfare gain from replacing the health insurance tax exclusion with lump-sum tax credits.

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Private Enterprise Research Center, Department of Economics, Texas A&M University, 4231 TAMU, College Station, TX 77843-4231, USA.


This paper analyzes the welfare gain from replacing the tax exclusion of employer-provided health insurance with a lump-sum tax credit. It differs from earlier studies in that we look at the welfare cost of health insurance tax exclusion as coming directly from excessive health insurance rather than from overconsumption of medical care and that we account for the labor market effect of the tax exclusion on welfare. Both differences work to produce a smaller tax reform welfare gain. For a set of mid-range parameter values, the welfare gain is about 21% of current health insurance tax expenditures. In addition, government tax expenditures would fall by 38%, and health insurance spending would fall by 77% after the reform.

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