Rising Cost of Healthcare
Finance: The Rising Cost of Health Care: Considering Meaningful Solutions for all Americans, November 19, 2025
We disagree with the Chairman on protecting the tax credit for Obamacare. The current controversy on the funding of subsidies is a holdover from the original debate in 2009. The fraudulently named Susan B. Anthony Fund did not have enough votes at that time to overextend the Hyde Amendment to the tax credits going to Obamacare participants. Where is Grover Norquist and Americans for Tax Reform when we need them - as the GOPO position can only be described as a tax increase.
The Fund is being too cute by half, as it is only attacking abortion coverage for poor beneficiaries - ignoring tax subsidies given for employer-provided insurance. Adding the Hyde Amendment to the health insurance exclusions would be a bridge too far for the pro-life movement to propose. If they had any integrity, they would go after everyone’s coverage. This says all you need to know about the movement.
For cases of late term abortion, coverage is essential as abortion may be necessary when life-saving care - such as chemo-therapy or a heart defect - can be complicated by pregnancy - with treatment fatal to the fetus or pregnancy to the mother. Doctors who see the poor need the same latitude to act in these situations must be equal to those who are covered by employer-provided insurance.
I urge members in both parties and both Chambers to ignore their empty threats - as no Republican will stay home next October at their behest - most GOP vote losses will come because of Trump. In the long term, replacing subsidies with a public option that also ends Medicaid would end the scaffolding on which the Hyde Amendment sits.
In general, we agree with Douglas Holz-Eakin. Government healthcare finance is a mess, combining employee payment, subsidized individual insurance, retirement insurance - with multiple funding streams, insurance for the poor, bankruptcy and long-term care for indigent seniors. Too many pieces and too many holes where people can get lost and remain untreated. However, we agree with Mr. Levits that this is not the time for ending Obamacare/COVID tax credits. This should have been litigated in Spring, not when the credits are about to expire.
Obamacare financing by the wealthy needs to be eliminated. It should be replaced with a free public option for people with pre-existing conditions who are denied coverage under other plans and care for the indigent (with senior Medicaid covered by a separate federal program funded by a goods and services (value added) tax.
The public option would be funded by an employer-paid net business receipts (subtraction value added) tax - with offsets for employer-paid coverage of marginal employees who are not covered or who cannot afford copayments as part of full-time employee coverage. The public option for the unemployed would be funded through the goods and services tax. Please see the first attachment for more detail on healthcare reform options previously submitted to the Committee.
Our tax proposal ends the filing of personal and business income (corporate) profits taxes. Small business and corporate tax benefits provided under these programs (the health insurance exclusion) would be excluded - but not credited - on employer paid subtraction VAT.
Poverty is the biggest cause of bad health. As we have stated before, the best avenue out of poverty for families is a higher child tax credit. The current credit, which is temporary, should be doubled or tripled as part of the next round of tax reform. With a higher minimum wage (which should be paid for those underserved by the education system to meet their opportunity costs for engaging in remedial education instead of low wage work, welfare or illegal activity), people will be able to afford better food choices.
Adding family sick leave assures that people can get care for their children during normal work hours. This saves society money in the short and long terms. Because marginal firms may not be able to afford this benefit, it should be provided as a subsidy to them as part of the enactment of an employer paid subtraction VAT, which is described in the second attachment on consumption taxes.
The testimony of Brian Blase should be wholly disregarded. Taken to its natural conclusion, all health insurance - including funds provided by employers under the health insurance exclusion - must be replaced with catastrophic insurance and healthcare lines of credit or savings accounts to cover immediate expenses. The Republican Party could have presented this approach in 2009 as an alternative to the Healthcare Reform Act. It did not because this approach does not pass the smell test.
The testimony of Bartley Armitage is enough evidence to support the need for both immediate subsidies and of the approach taken by Blase. It also supports the extension of the Public Option to anyone with either preexisting conditions and/or the inability to pay for comprehensive insurance - or even Obamacare without the current subsidy.
Attachment: Single Payer
Attachment: Consumption Taxes









