Health Care Reform Through the Tax and Budget Reconciliation Process

Abstract

The tax and budget reconciliation process could be used to substantially expand health insurance coverage and improve health insurance outcomes. Potential health-related items, which could be included in a tax and reconciliation bill, include expansions in Medicaid eligibility and federal Medicaid funding, new tax credits for subsidies of state exchange insurance by small businesses for employees, tax credits for contributions to health savings accounts, and additional risk-adjustment subsidies for complex health care cases. These health-related tax and budget provisions would alleviate economic turmoil and hardships associated with the COVID pandemic. Moreover, these provisions are, if structured properly, likely to satisfy the constraints of the Byrd rule defining eligibility for inclusion in a reconciliation bill.