Congratulations, It’s a Behemoth!

Senate health bill beats House counterpart in size, scope and reach, introduces bevy of new and increased taxes to the American people

Well, well, well — here we go again.

At 2,074 pages, Harry Reid’s Senate Health Care Reform bill has started even larger than Nancy Pelosi’s counterpart in the House of Representatives which, as delivered, topped out at a scant-by-comparison 1,990 pages.

Also, while the House bill used the word “shall”–the governmental equivalent of a doctor telling a patient to turn their head and cough–a whopping 3,425 times, the just-released Senate version used the same word 3,607 times. And, while the words “tax” and “taxable” were used 87 and 62 times, respectively, in Pelosi’s nightmare, the same words were used 183 and 164 times in Reid’s version.

Silly me — I didn’t realize this was a race.

Like it’s counterpart in the House of Representatives, H.R. 3590 is the evisceration of the American health care system, destruction of the American economy, and erosion of American freedom, all rolled into one giant package. Increased taxes on individuals and small businesses will only serve to further encumber American families, increase unemployment, and stifle economic growth.

And, as if on cue, from Americans For Tax Reform we have a list of tax hikes proposed in the Reid bill. While I doubt it is complete, it is certainly a start:

  • Individual Mandate Tax (Page 324/Sec. 1501/$8 bil): Starting in 2014, anyone not buying “qualifying” health insurance must pay an income surtax . . . capped at 8 percent of income. Exemptions for religious objectors, undocumented immigrants, prisoners, those earning less than the poverty line, members of Indian tribes, and hardship cases (determined by HHS).
  • Employer Mandate Tax (Page 348/Sec. 1513/$28 bil): If an employer does not offer health coverage, and at least one employee qualifies for a health tax credit, the employer must pay an additional non-deductible tax of $750 for all full-time employees. Applies to all employers with 50 or more employees. If the employer requires a waiting period to enroll in coverage of 30-60 days, there is a $400 tax per employee ($600 if the period is 60 days or longer).
  • Excise Tax on Comprehensive Health Insurance Plans (Page 1979/Sec. 9001/$149.1 bil): Starting in 2013, new 40 percent excise tax on “Cadillac” health insurance plans ($8500 single/$23,000 family). Higher threshold ($9850 single/$26,000 family) for early retirees and high-risk professions. CPI +1 percentage point indexed. From 2013-2015, the 17 highest-cost states are 120% of this level.
  • Employer Reporting of Insurance on W-2 (Page 1996/Sec. 9002/Min$): Preamble to taxing health benefits on individual tax returns.
  • Medicine Cabinet Tax (Page 1997/Sec. 9003/$5 bil): No longer allowable to use health savings account (HSA), flexible spending account (FSA), or health reimbursement (HRA) pre-tax dollars to purchase non-prescription, over-the-counter medicines (except insulin)
  • HSA Withdrawal Tax Hike (Page 1998/Sec. 9004/$1.3 bil): Increases additional tax on non-medical early withdrawals from an HSA from 10 to 20 percent, disadvantaging them relative to IRAs and other tax-advantaged accounts, which remain at 10 percent.
  • FSA Cap (Page 1999/Sec. 9005/$14.6 bil): Imposes cap on FSAs of $2500 (now unlimited).
  • Corporate 1099-MISC Information Reporting (Page 1999/Sec. 9006/$17.1 bil): Requires businesses to send 1099-MISC information tax forms to corporations (currently limited to individuals), a huge compliance burden for small employers.
  • Excise Tax on Charitable Hospitals (page 2001/Sec. 9007/Min$): $50,000 per hospital if they fail to meet new “community health assessment needs,” “financial assistance,” and “billing and collection” rules set by HHS.
  • Tax on Innovator Drug Companies (Page 2010/Sec. 9008/ $22.2 bil): $2.3 billion annual tax on the industry imposed relative to share of sales made that year.
  • Tax of Medical Device Manufacturers (Page 2020/Sec. 9009/$19.3 bil): $2 billion annual tax on the industry imposed relative to shares of sales made that year. Exempts items retailing for <$100.
  • Tax on Health Insurers (Page 2026/Sec. 9010/$60.4 bil): $6.7 billion annual tax on the industry imposed relative to health insurance premiums collected that year.
  • Eliminate tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D (Page 2034/Sec. 9012/$5.4 bil)
  • Raise “Haircut” for Medical Itemized Deduction from 7.5% to 10% of AGI (Page 2034/Sec. 9013/$15.2 bil) : Waived for 65+ taxpayers in 2013-2016 only
  • $500,000 Annual Executive Compensation Limit for Health Insurance Executives (Page 2035/Sec. 9014/$0.6 bil)
  • Hike in Medicare Payroll Tax (Page 2040/Sec. 9015/$53.8 bil)
  • Blue Cross/Blue Shield Tax Hike (Page 2044/Sec. 9016/$0.4 bil): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services.
  • Tax on Cosmetic Medical Procedures (Page 2045/Sec. 9017/$5.8 bil): New 5% excise tax on elective cosmetic surgery to be paid by the surgery patient.


  1. William A. Rose says:

    I have tried, and failed, to find the language concerning being fined and jailed if a person does not have health care. You all might recall Pelosi recently stated that such a penalty was fine with her.

  2. Anonymous says:

    I'd have to read all the bills again to be sure, but here is what I remember…(and I could be wrong and it could have changed with all the updates they are making.)

    You will be fined if you don't have insurance. How will they know you don't have insurance and how will they fine you?

    You have to prove you have insurance when you file income taxes. If you have a "golden" plan they can tax, they will tax it then.

    If you have a private plan that isn't taxable, so be it.

    If you don't have a plan then the IRS applies a penalty, which is the fine (a certain percent of your income up to a capped amount). It comes out of your refund or, if no refund is due, then the IRS will send you a bill for the penalty fine.

    What happens if you don't pay the IRS bill? Therein is the excessive fine and possible jail term.

    If I'm wrong please correct my words as I want to be accurate on this.

  3. Boston Blackie says:

    Anon 3:24 – You are correct, we already have universal healthcare in mASSachusetts. We MUST attach a form from our healthcare provider with our tax returns detailing the provider's plan number along with all family members under that plan number. It includes all our personal info. If the state does not get that info, you get no refund and they then fine you. The insurance company also must provide this info directly to the state to match. In addition, employers are required to provide a list of all their employees and their insurance plans. Since I do not take my health insurance through my employee, I must sign a form verifying that I do have insurance but through another plan so the company does not also get fined.
    This was put in place with Romney as governor.

  4. Dee says:

    In reading the above comments, it appears that the Federal Government will have all this info on your insurance or lack of and possibly your financial accounts. It also appears that the Federal Government will have access to your health records. What about HIPPA? There will be no way that I will allow them to have access to my health records. They can send me to jail. I do have to read more of the Bill.

  5. Anonymous says:


    Call your senator! Democrats just announced "vote to proceed" to the Reid-Obama health care takeover set for Saturday at 8pm.

  6. Gail B says:

    Golly, Jeff! Do you ever run into Glenn Beck? He pointed out the same taxes (and even more) on his show today.

    Bottom line: The whole mess turns my stomach!

  7. Lynn says:

    Reid's so-called "health care" bill includes abortion funding under the gov't option.

    Here is the direct link:

    TITLE: Sen. Reid’s Government-Run Health Plan Requires a Monthly Abortion Fee

    Posted by GOP Leader Press Office on November 19th, 2009

    Follow @GOPLeader on Twitter for updates.

    Just like the original 2,032-page, government-run health care plan from Speaker Nancy Pelosi’s (D-CA), Senate Majority Leader Harry Reid’s (D-NV) massive, 2,074-page bill would levy a new “abortion premium” fee on Americans in the government-run plan.

    Beginning on line 7, p. 118, section 1303 under “Voluntary Choice of Coverage of Abortion Services” the Health and Human Services Secretary is given the authority to determine when abortion is allowed under the government-run health plan. Leader Reid’s plan also requires that at least one insurance plan offered in the Exchange covers abortions (line 13, p. 120).

    What is even more alarming is that a monthly abortion premium will be charged of all enrollees in the government-run health plan. It’s right there beginning on line 11, page 122, section 1303, under “Actuarial Value of Optional Service Coverage.” The premium will be paid into a U.S. Treasury account – and these federal funds will be used to pay for the abortion services.

    Section 1303(a)(2)(C) describes the process in which the Health Benefits Commissioner is to assess the monthly premiums that will be used to pay for elective abortions under the government-run health plan and for those who are given an affordability credit to purchase insurance coverage that includes abortion through the Exchange. The Commissioner must charge at a minimum $1 per enrollee per month.


  8. Brandon says:

    Wow this is just amazing that anyone would think that this is a good idea.
    Assess fines for those who still cannot afford health care, there are many people who make enough to put food on the table, and put a roof over their heads and not much else, and they live above the poverty line. So all those people will now have to go without eating or take to the streets.
    A tax on manufacturers who make medical equipment is just stupid as it drives up the cost of medical equipment. Same thing for pharmaceutical companies.
    And then to tax health insurance providers…now that's a great way to create a single payer system without directly creating a single payer system. Just make any other health insurance so far out of reach from the general public that it is simply unrealistic to purchase that health insurance. Thus the health insurance companies crumble and fall to the wayside or only service the rich elite, who will also have more taxes to pay.


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