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The Supreme Court's decision on the Affordable Care Act settled the question of its constitutionality, but only seemed to intensify debate over the law.
Ohio Treasurer Josh Mandel joined other Republicans in calling for its repeal, saying the decision "sets the stage for the November election." He identified the law as a pivotal issue in his campaign to unseat incumbent U.S. Sen. Sherrod Brown.
Mandel issued a statement on the day of the decision asserting that Brown had voted "for what will likely go down as the biggest tax increase in history."
That claim about the health care legislation has been a talking point opponents of the law, repeated many times since the ruling. But PolitiFact first examined it after Florida Gov. Rick Scott made the statement more than a year earlier.
The claim is wrong. Here’s why:
The federal Joint Committee on Taxation, a nonpartisan committee of Congress with a professional staff of economists, attorneys and accountants, gave members a detailed breakdown of the tax impact of the health care law from 2010-2019.
• A 10 percent excise tax on indoor tanning services that started in 2011 is expected to bring in $2.7 billion over 10 years.
• A new fee for pharmaceutical manufacturers and importers that started in 2011 is expected to raise $27 billion over 10 years.
• Starting in 2013, Medicare payroll taxes increase 0.9 percentage points for people with annual incomes over $200,000 ($250,000 for couples filing jointly). Also, people at this income level would pay a new 3.8 percent tax on investment income. The 10-year cost: $210.2 billion.
• Starting in 2013, a 2.3 percent excise tax on manufacturers and importers of certain medical devices starts. The 10-year total: $20 billion.
• Starting in 2013, the floor on medical expense deductions on itemized income tax returns will be raised from 7.5 percent to 10 percent of income. That's expected to bring in $15.2 billion over the next 10 years.
• Starting in 2014, a new annual fee on health insurance providers begins. Total estimated 10-year revenue: $60.1 billion.
• Starting in 2018, a new 40 percent excise tax kicks in on high-cost health plans, so-called "Cadillac plans" (over $10,200 for individuals, $27,500 for families). That's expected to bring the government a total of $32 billion in 2018 and 2019.
There also is money in the law going the other way. The plan includes government money, in the form of tax credits, to subsidize the cost of health insurance for lower-income people who don't get insurance through their employer. And there is a tax cut for some small businesses that allows them to write off a portion of the cost of providing insurance to their employees.
Combined with various other revenue-generating provisions, the Joint Committee on Taxation estimates the health law will bring in more than $437.8 billion by 2019. The government's nonpartisan Congressional Budget Office estimated the additional revenues coming in to the government to be $525 billion between now and 2019.
Does that translate to the biggest tax increase in American history?
There are many ways to define or measure the size of a tax increase. The health care tax provisions, for instance, take effect between 2011 and 2018, meaning the full effect of the legislation won't be felt until near the end of the decade. On top of that to compare the costs today with other years you have to adjust for inflation to measure the relative impact of a tax provision at the time it was enacted.
For our comparison, PolitiFact used a method perfected by Jerry Tempalski, an analyst in the Office of Tax Analysis with the U.S. Department of the Treasury. In 2006, Tempalski tried to determine the relative impact of major tax revenue bills from 1940-2006. He used revenue estimates from Treasury and the Joint Committee on Taxation and calculated the impact as a percentage of GDP.
For 1940-1967 calculations, he used a single-year snapshot of the revenue impact of the tax legislation. For more recent tax bills, from 1968-2006, Tempalski used a two-year average of the revenue effects. Tempalski wrote: "The comparison of tax bills for the first period should be examined with some caution, because the revenue estimates are from different sources and are not completely consistent. The comparison for the second period can be viewed with more confidence, because the estimates are relatively consistent."
As a percent of GDP, here are the top five tax increases from 1940-2006, according to Tempalski:
1. Revenue Act of 1942: 5.04 percent of GDP;
2. Revenue Act of 1961: 2.2 percent of GDP;
3. Current Tax Payment Act of 1943: 1.13 percent of GDP;
4. Revenue and Expenditure Control Act of 1968: 1.09 percent of GDP;
5. Excess Profits Tax of 1950: .97 percent of GDP;
And here are the top five tax increases from the "modern" era of 1968-2006:
1. Revenue and Expenditure Control Act of 1968: 1.09 percent of GDP;
2. Tax Equity and Fiscal Responsibility Act of 1982: 0.8 percent of GDP;
3 (tie). Crude Oil Windfall Profit Tax Act of 1980: 0.5 percent of GDP
3 (tie). Omnibus Budget Reconciliation Act of 1993; 0.5 percent of GDP;
5. Omnibus Budget Reconciliation Act of 1990; 0.49 percent of GDP.
The list does not include the health care law, which passed in 2010, and a spokeswoman for the Department of Treasury said it hasn't been updated. So PolitiFact calculated its own figure for percent of GDP. We used 2019 as our baseline because that's when all of the tax provisions of the law will be in effect. In 2019, the CBO estimates, the government will see increased revenues of $104 billion.
That $104 billion includes the penalty or tax that individuals might pay if they do not purchase health insurance -- a figure estimated to be $14 billion for 2019.
We then divided that number into the projected GDP for 2019, which according to the CBO economic forecast is $21.164 trillion. That would mean the tax increase provisions of the health care law would amount to 0.49 percent of total GDP.
That would mean the tax increases resulting from the health care law would be about the size of tax increases proposed and passed in 1980 by President Jimmy Carter, in 1990 by President George H.W. Bush and in 1993 by President Bill Clinton.
The health care-related tax increases are smaller than the tax increase signed into law by President Ronald Reagan in 1982 and a temporary tax signed into law in 1968 by President Lyndon B. Johnson. And they are significantly smaller than two tax increases passed during World War II and a tax increase passed in 1961.
We asked Mandel's campaign how his claim is supported. The most relevant source they cited was an editorial from the Wall Street Journal asserting that Obama "has imposed the largest tax increase in history on the middle class."
The Journal cited Congressional Budget Office projections that 76 percent of the people who will have to pay an annual penalty tax (because they do not have health insurance and are not exempt for, say, cases of hardship or religious belief) will have a household income of 500 percent of the federal poverty level or below. For a family of four, that comes to about $120,000.
But who pays the tax is a different question than whether it is the largest tax increase in history.
Mandel's camp also cited sources saying that the Affordable Care Act contains "the largest tax increase since 1993," which we noted earlier and which was not his statement.
And they cited a chart from FactCheck.org showing the Affordable Care Act producing the largest tax increase since 1968 in raw dollars. In the article the chart accompanied, however, FactCheck.org called raw dollars a "rather useless yardstick" and "a poor way to measure the size of a tax increase," because it makes no adjustment for inflation and takes no account of a population that is steadily rising.
The tax increases in the health care legislation do reverse a trend of federal tax cuts and represent the first significant tax increases since 1993. But they are not the largest in the history of the United States.
It would have to grow more than 10 fold to match the wartime tax increase from 1942. It would have to nearly double just to match the 1982 increase under Reagan. And that still wouldn’t crack the top 5 since 1940.
They are so far from the largest that it is not now possible, much less "likely," that they will "go down as the biggest tax increase in history."
On the Truth-O-Meter, Mandel’s claim rates Pants on Fire.
Josh Mandel Campaign, "Ohio Treasurer Josh Mandel responds to U.S. Supreme Court ruling on the Affordable Care Act," June 28, 2012
Email from Mandel communications director Travis Considine, July 14, 2012
PolitiFact, "Limbaugh, GOP have it wrong: Health care law is not the largest tax increase ever," June 28, 2012
PolitiFact Florida, "Rick Scott says health care law is biggest tax increase in U.S. history," Feb. 14, 2011
PolitiFact, "Facebook post says "75 percent of the Obamacare tax falls on the middle class," July 9, 2012
Joint Committee on Taxation, tax impact for the federal health care bill, accessed Feb. 7, 2011
PolitiFact, "Bush I, Clinton and Reagan all pushed taxes higher than the bump from Obama's health care bill," March 25, 2010
CBO, revenue and tax estimates of federal health care bill 2011-2019, accessed Feb. 8, 2011
Department of Treasury, Revenue impacts of major tax legislation 1940-2006, accessed Feb. 8, 2011
Wall Street Journal, "It's Up to the Voters Now," June 28, 2012
PolitiFact Florida, "Health care law 'largest tax increase in history on the middle class,' says TV ad," July 11, 2012
FactCheck.org, "Biggest Tax Increase in History?," July 10, 2012
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