Universal HealthcareBy NextBestFit
Phase 1: Enactment & build · Step 1.12

Set up the new taxes

Months 0–18 · Treasury, IRS, SSADiscuss this step
fiscallikelihood: mediumimpact: high

Costs come in at the costly case

Provider lobbying raises rates, induced demand is higher, and drug savings are smaller. The ledger's costly case adds about $842.8B a year in required general revenue.

Early warning signs
  • First-year actual vs. ledger by line
  • Rates Board recommendations overridden
Mitigation
  • Automatic household-premium adjustment
  • Standby copay option
  • Spending growth target

Implementation risks

RiskMitigation
Top-end taxes raise less than estimated (costly case: $250.0B instead of $330.1B).An automatic trigger raises the household premium rate by 0.25 points if the trust-fund reserve falls below 1 month.