NOT FOR CITATION OR ATTRIBUTION WITHOUT THE AUTHORS’ PERMISSION AEA/HERO: Cost and Coverage Implications of Health Insurance Reforms, Jan 4, 2009. Congressional Budget Office

INTRODUCTION Including entitlement programs and tax incentives, the scope of federal efforts to help nonelderly residents obtain health care coverage is considerable. In 2007, the federal government spent roughly $130 billion on subsidized health insurance provided to nonelderly low-income people through the federal--state Medicaid program and the State Children’s Health Insurance Program (SCHIP). In addition, the Joint Committee on Taxation has estimated that the total federal tax expenditure associated with the exclusion for employment-based health insurance was $246 billion in 2007, consisting of $145 billion in foregone income taxes and $101 billion in payroll taxes.