How_RRQ to_TO pay_VVI for_IF health_NN1 care_NN1 reform_NN1 ?_? 
Maybe_RR these_DD2 new_JJ taxes_NN2 WASHINGTON_NP1 --_JJ Democratic_JJ leaders_NN2 ,_, worried_VVD that_CST high_JJ price_NN1 tags_NN2 might_VM derail_VVI their_APPGE health_NN1 care_NN1 plans_NN2 ,_, are_VBR looking_VVG at_II a_AT1 raft_NN1 of_IO ideas_NN2 both_RR old_JJ and_CC new_JJ to_TO salvage_VVI their_APPGE legislation_NN1 ._. 
Each_DD1 proposal_NN1 carries_VVZ risks_NN2 of_IO its_APPGE own_DA ,_, however_RR ,_, lawmakers_NN2 and_CC outside_JJ experts_NN2 said_VVD ._. 
Democrats_NN2 in_II the_AT House_NN1 of_IO Representatives_NN2 ,_, for_REX21 example_REX22 ,_, acknowledge_VV0 that_CST they_PPHS2 're_VBR looking_VVG at_II a_AT1 value-added_JJ tax_NN1 ,_, which_DDQ is_VBZ used_VVN widely_RR in_II Europe_NP1 but_CCB has_VHZ never_RR gone_VVN anywhere_RL in_II the_AT U.S._NP1 Also_RR on_II the_AT table_NN1 are_VBR a_AT1 2_MC percent_NNU surtax_NN1 on_II the_AT income_NN1 of_IO the_AT wealthy_JJ and_CC a_AT1 hike_NN1 in_II taxes_NN2 on_II sodas_NN2 ._. 
"_" The_AT average_JJ American_NN1 is_VBZ already_RR worried_VVN about_II government_NN1 intrusion_NN1 ,_, "_" said_VVD Mark_NP1 V._II Pauly_NP1 ,_, an_AT1 economist_NN1 at_II the_AT Wharton_NP1 School_NN1 of_IO the_AT University_NN1 of_IO Pennsylvania_NP1 ,_, and_CC the_AT soda_NN1 tax_NN1 "_" sounds_VVZ like_II the_AT school_NN1 nurse_NN1 ._. "_" 
Rep._NNB Robert_NP1 Andrews_NP1 ,_, D-N.J._NP1 ,_, the_AT chairman_NN1 of_IO an_AT1 Education_NN1 and_CC Labor_NN1 subcommittee_NN1 ,_, acknowledged_VVD ,_, "_" Every_AT1 revenue_NN1 raiser_NN1 is_VBZ something_PN1 someone_PN1 does_VDZ n't_XX like_VVI ._. "_" 
He_PPHS1 added_VVD ,_, however_RR ,_, "_" What_DDQ we_PPIS2 're_VBR going_VVGK to_TO have_VHI to_TO find_VVI is_VBZ the_AT right_NN1 ,_, equitable_JJ mix_NN1 of_IO policy_NN1 and_CC politics_NN1 to_TO get_VVI this_DD1 done_VDN ._. "_" 
In_II the_AT Senate_NN1 ,_, Democrats_NN2 are_VBR scrambling_VVG to_TO shrink_VVI the_AT Finance_NN1 Committee_NN1 's_GE legislation_NN1 after_II a_AT1 preliminary_JJ estimate_NN1 from_II the_AT Congressional_JJ Budget_NN1 Office_NN1 put_VVD the_AT bill_NN1 's_GE cost_NN1 at_II $1.6_NNU trillion_NNO over_RG 10_MC years_NNT2 ._. 
They_PPHS2 're_VBR scaling_VVG back_RP subsidies_NN2 for_IF families_NN2 to_TO buy_VVI insurance_NN1 ,_, one_MC1 of_IO the_AT most_RGT expensive_JJ parts_NN2 of_IO the_AT bill_NN1 ._. 
Lawmakers_NN2 in_II both_DB2 chambers_NN2 are_VBR trying_VVG to_TO bring_VVI their_APPGE bills_NN2 '_GE price_NN1 tags_VVZ to_II below_RG $1_NNU trillion_NNO over_RG 10_MC years_NNT2 ._. 
Besides_RR considering_VVG new_JJ taxes_NN2 and_CC scaled-back_NN1 subsidies_NN2 ,_, lawmakers_NN2 are_VBR turning_VVG to_II employers_NN2 to_TO help_VVI pay_NN1 for_IF the_AT costs_NN2 of_IO insuring_VVG their_APPGE workers_NN2 ._. 
Here_RL 's_VBZ a_AT1 rundown_NN1 of_IO some_DD of_IO the_AT ways_NN2 they_PPHS2 're_VBR trying_VVG to_TO crack_VVI the_AT cost_NN1 problem_NN1 :_: VALUE-ADDED_JJ TAX_NN1 The_AT value-added_JJ tax_NN1 ,_, which_DDQ taxes_VVZ goods_NN2 at_II each_DD1 stage_NN1 of_IO production_NN1 ,_, has_VHZ been_VBN floating_VVG around_RP as_II a_AT1 potential_JJ revenue_NN1 raiser_NN1 for_IF decades_NNT2 ._. 
However_RR ,_, it_PPH1 's_VHZ been_VBN considered_VVN radioactive_JJ since_CS House_NN1 Ways_NN2 and_CC Means_VVZ Committee_NN1 Chairman_NN1 Al_NP1 Ullman_NP1 ,_, D-Ore._NP1 ,_, was_VBDZ defeated_VVN in_II 1980_MC after_II talking_VVG up_RP the_AT levy_NN1 ._. 
The_AT VAT_NN1 ,_, which_DDQ is_VBZ essentially_RR a_AT1 consumption_NN1 tax_NN1 ,_, is_VBZ regressive_JJ ,_, which_DDQ means_VVZ it_PPH1 hits_VVZ lower-income_JJ people_NN harder_RRR than_CSN upper-income_JJ people_NN ,_, making_VVG it_PPH1 unpopular_JJ among_II liberal_JJ economists_NN2 and_CC labor_NN1 and_CC consumer_NN1 groups_NN2 ._. 
Nevertheless_RR ,_, the_AT VAT_NN1 has_VHZ gotten_VVN a_AT1 lot_NN1 of_IO attention_NN1 from_II academia_NN1 and_CC research_NN1 centers_NN2 as_II a_AT1 funder_NN1 of_IO a_AT1 health_NN1 care_NN1 overhaul_NN1 ,_, and_CC it_PPH1 has_VHZ some_DD influential_JJ proponents_NN2 ._. 
Ezekiel_NP1 J._NP1 Emanuel_NP1 ,_, a_AT1 special_JJ adviser_NN1 for_IF health_NN1 policy_NN1 in_II the_AT Office_NN1 of_IO Management_NN1 and_CC Budget_NN1 ,_, has_VHZ written_VVN favorably_RR about_II using_VVG a_AT1 VAT_NN1 tax_NN1 to_TO finance_VVI a_AT1 health_NN1 care_NN1 overhaul_NN1 ._. 
He_PPHS1 's_VBZ the_AT brother_NN1 of_IO White_NP1 House_NN1 Chief_NN1 of_IO Staff_NN Rahm_NP1 Emanuel_NP1 ._. 
Leonard_NP1 Burman_NP1 ,_, the_AT director_NN1 of_IO the_AT Tax_NN1 Policy_NN1 Center_NN1 ,_, a_AT1 joint_JJ project_NN1 of_IO the_AT Urban_JJ Institute_NN1 and_CC Brookings_NP1 Institution_NN1 ,_, also_RR has_VHZ advocated_VVN a_AT1 VAT_NN1 tax_NN1 ._. 
A_AT1 value-added_JJ tax_NN1 of_IO 1_MC1 percent_NNU to_II 1.5_MC percent_NNU could_VM raise_VVI $600_NNU billion_NNO over_RG 10_MC years_NNT2 ,_, according_II21 to_II22 estimates_NN2 that_CST are_VBR circulating_VVG on_II Capitol_NP1 Hill_NP1 ._. 
If_CS necessities_NN2 such_II21 as_II22 housing_NN1 ,_, education_NN1 and_CC medical_JJ care_NN1 were_VBDR exempted_VVN to_TO soften_VVI the_AT blow_NN1 for_IF lower-income_JJ people_NN ,_, then_RT the_AT rate_NN1 might_VM have_VHI to_TO increase_VVI slightly_RR to_TO raise_VVI the_AT same_DA amount_NN1 ._. 
Many_DA2 are_VBR skeptical_JJ that_CST Congress_NN1 would_VM ever_RR approve_VVI a_AT1 VAT_NN1 ._. 
Jonathan_NP1 Oberlander_NP1 ,_, who_PNQS teaches_VVZ health_NN1 policy_NN1 at_II the_AT University_NN1 of_IO North_ND1 Carolina_NP1 at_II Chapel_NP1 Hill_NNL1 ,_, said_VVD he_PPHS1 'd_VM be_VBI surprised_JJ if_CS the_AT VAT_NN1 made_VVD the_AT final_JJ cut_NN1 of_IO revenue_NN1 raisers_NN2 ._. 
"_" Health_NN1 care_NN1 reform_NN1 has_VHZ enough_DD problems_NN2 as_CSA it_PPH1 is_VBZ without_IW taking_VVG on_RP the_AT VAT_NN1 ,_, "_" he_PPHS1 said_VVD ._. 
Still_RR ,_, he_PPHS1 said_VVD ,_, at_II this_DD1 point_NN1 in_II the_AT process_NN1 ,_, "_" It_PPH1 's_VBZ basically_RR a_AT1 question_NN1 of_IO which_DDQ poison_NN1 or_CC poisons_NN2 do_VD0 you_PPY want_VVI to_TO drink_VVI ?_? "_" 
SURTAX_VV0 ON_II THE_AT WEALTHY_JJ The_AT Ways_NN2 and_CC Means_VVZ panel_NN1 also_RR is_VBZ discussing_VVG a_AT1 2_MC percent_NNU surtax_NN1 on_II the_AT incomes_NN2 of_IO the_AT wealthy_JJ ._. 
Such_DA a_AT1 surtax_NN1 would_VM target_VVI taxpayers_NN2 who_PNQS earn_VV0 more_DAR than_CSN $200,000_NNU annually_RR or_CC households_NN2 that_CST earn_VV0 more_DAR than_CSN $250,000_NNU ._. 
It_PPH1 would_VM raise_VVI an_AT1 estimated_JJ $256_NNU billion_NNO over_II a_AT1 decade_NNT1 ,_, according_II21 to_II22 the_AT estimates_NN2 floating_VVG on_II Capitol_NP1 Hill_NP1 ._. 
Unlike_II some_DD of_IO the_AT other_JJ tax_NN1 proposals_NN2 on_II the_AT table_NN1 ,_, this_DD1 one_PN1 would_VM meet_VVI President_NNB Barack_NP1 Obama_NP1 's_GE campaign_NN1 promise_NN1 of_IO no_AT new_JJ taxes_NN2 for_IF Americans_NN2 who_PNQS earn_VV0 less_DAR than_CSN $200,000_NNU a_AT1 year_NNT1 ._. 
Oberlander_NP1 said_VVD that_CST a_AT1 surtax_NN1 was_VBDZ the_AT "_" most_RGT straightforward_JJ way_NN1 to_TO finance_VVI reform_NN1 from_II a_AT1 Democratic_JJ perspective_NN1 ,_, "_" although_CS it_PPH1 opens_VVZ Democrats_NN2 up_II21 to_II22 accusations_NN2 of_IO "_" class_NN1 warfare_NN1 ._. "_" 
Pauly_RR agreed_VVN that_CST such_DA a_AT1 surtax_NN1 is_VBZ "_" probably_RR the_AT way_NN1 you_PPY have_VH0 to_TO go_VVI ,_, "_" but_CCB added_VVD that_CST it_PPH1 would_VM n't_XX raise_VVI enough_DD money_NN1 ._. 
"_" You_PPY have_VH0 to_TO be_VBI honest_JJ and_CC say_VV0 if_CS we_PPIS2 're_VBR going_VVGK to_TO have_VHI to_TO go_VVI down_RP the_AT income_NN1 distribution_NN1 to_TO get_VVI the_AT money_NN1 ,_, "_" he_PPHS1 said_VVD ._. 
MEDICARE_NP1 PAYROLL_NN1 TAX_NN1 INCREASE_VV0 Another_DD1 possibility_NN1 :_: increasing_VVG the_AT Medicare_NP1 payroll_NN1 tax_NN1 ,_, which_DDQ the_AT employer_NN1 and_CC the_AT employee_NN1 pay_NN1 ._. 
An_AT1 increase_NN1 of_IO 0.65_MC percentage_NN1 point_NN1 would_VM raise_VVI $600_NNU billion_NNO over_II a_AT1 decade_NNT1 ,_, according_II21 to_II22 the_AT estimates._NNU 'SIN'_NP1 TAX_VV0 Some_DD economists_NN2 support_VV0 another_DD1 idea_NN1 that_CST 's_VBZ under_II consideration_NN1 :_: raising_VVG "_" sin_NN1 taxes_NN2 ._. "_" 
Such_DA penalties_NN2 ,_, they_PPHS2 say_VV0 ,_, could_VM help_VVI discourage_VVI unhealthy_JJ behavior_NN1 ._. 
Jonathan_NP1 Gruber_NP1 ,_, a_AT1 professor_NN1 of_IO economics_NN1 at_II the_AT Massachusetts_NP1 Institute_NN1 of_IO Technology_NN1 ,_, said_VVD he_PPHS1 preferred_VVD sin_NN1 taxes_NN2 to_II a_AT1 VAT_NN1 or_CC payroll_NN1 tax_NN1 ._. 
In_RR21 addition_RR22 ,_, he_PPHS1 'd_VM rather_RR see_VVI a_AT1 tax_NN1 on_II alcohol_NN1 than_CSN on_II sodas_NN2 ._. 
Still_RR ,_, he_PPHS1 said_VVD ,_, the_AT revenue_NN1 from_II sin_NN1 taxes_NN2 would_VM be_VBI relatively_RR small_JJ and_CC would_VM n't_XX rise_VVI with_IW the_AT cost_NN1 of_IO health_NN1 care_NN1 ._. 
Overall_RR ,_, he_PPHS1 hopes_VVZ that_CST a_AT1 health_NN1 care_NN1 overhaul_NN1 is_VBZ financed_VVN primarily_RR by_II making_VVG changes_NN2 in_II the_AT health_NN1 care_NN1 system_NN1 and_CC by_II taxing_VVG employer-provided_JJ health_NN1 benefits_NN2 ,_, as_RR21 well_RR22 imposing_VVG a_AT1 sin_NN1 tax_NN1 ._. 
EMPLOYERS_NN2 Lawmakers_NN2 in_II the_AT House_NN1 and_CC the_AT Senate_NN1 are_VBR looking_VVG to_II employers_NN2 to_TO help_VVI pay_NN1 for_IF revamping_VVG health_NN1 care_NN1 ,_, but_CCB they_PPHS2 're_VBR going_VVG about_II it_PPH1 in_II different_JJ ways_NN2 ._. 
House_NN1 Democrats_NN2 ,_, in_II a_AT1 draft_NN1 released_VVD Friday_NPD1 ,_, proposed_VVD an_AT1 8_MC percent_NNU payroll_NN1 tax_NN1 on_II employers_NN2 who_PNQS do_VD0 n't_XX offer_VVI insurance_NN1 ._. 
Some_DD small_JJ businesses_NN2 would_VM be_VBI exempt_JJ ._. 
A_AT1 Senate_NN1 Finance_NN1 Committee_NN1 outline_VV0 that_CST leaked_VVD last_MD week_NNT1 details_NN2 a_AT1 variety_NN1 of_IO options_NN2 for_IF employers_NN2 ,_, including_II one_PN1 that_CST does_VDZ n't_XX require_VVI them_PPHO2 to_TO offer_VVI coverage_NN1 ._. 
In_II that_DD1 case_NN1 ,_, they_PPHS2 'd_VM be_VBI required_VVN to_TO shoulder_VVI half_DB the_AT cost_NN1 if_CS their_APPGE workers_NN2 ended_VVD up_RP on_II Medicaid_NP1 ,_, the_AT state-federal_JJ program_NN1 for_IF the_AT poor_JJ ,_, or_CC 100_MC percent_NNU of_IO the_AT cost_NN1 if_CS their_APPGE employees_NN2 received_VVD tax_NN1 credits_VVZ to_TO subsidize_VVI buying_VVG insurance_NN1 through_II newly_RR created_VVN exchanges_NN2 ._. 
The_AT provision_NN1 is_VBZ designed_VVN to_TO assuage_VVI critics_NN2 ,_, who_PNQS say_VV0 that_CST ,_, given_VVN the_AT chance_NN1 ,_, some_DD employers_NN2 would_VM simply_RR shift_VVI the_AT responsibility_NN1 for_IF their_APPGE employees_NN2 '_GE insurance_NN1 to_II the_AT federal_JJ government_NN1 ._. 
The_AT amount_NN1 of_IO the_AT potential_JJ Medicaid_JJ charge_NN1 is_VBZ n't_XX spelled_VVN out_RP ,_, but_CCB in_II 2006_MC the_AT annual_JJ average_NN1 Medicaid_VVD cost_NN1 per_II adult_NN1 was_VBDZ figured_VVN at_II about_RG $2,100_NNU ,_, according_II21 to_II22 the_AT Urban_JJ Institute_NN1 and_CC the_AT Kaiser_NNB Commission_NP1 on_II Medicaid_NP1 and_CC the_AT Uninsured_JJ ._. 
(_( The_AT commission_NN1 ,_, like_II Kaiser_NNB Health_NP1 News_NN1 ,_, is_VBZ part_NN1 of_IO the_AT Kaiser_NNB Family_NP1 Foundation_NN1 ,_, a_AT1 nonpartisan_JJ research_NN1 organization_NN1 ._. )_) 
"_" They_PPHS2 're_VBR saying_VVG ,_, if_CS you_PPY shift_VV0 your_APPGE employees_NN2 onto_II us_PPIO2 (_( the_AT government_NN1 health_NN1 plans_NN2 )_) ,_, you_PPY 'll_VM still_RR have_VHI to_TO pay_VVI for_IF them_PPHO2 ,_, "_" said_VVD Paul_NP1 Fronstin_NP1 of_IO the_AT Employee_NN1 Benefit_NN1 Research_NN1 Institute_NN1 ,_, a_AT1 nonpartisan_JJ research_NN1 organization_NN1 in_II Washington_NP1 ._. 
Requiring_VVG employers_NN2 to_TO help_VVI finance_NN1 Medicaid_VVN and_CC the_AT tax_NN1 credits_VVZ helps_NN2 solve_VVI the_AT financing_NN1 problem_NN1 ,_, but_CCB it_PPH1 mainly_RR affects_VVZ companies_NN2 with_IW low-income_JJ workers_NN2 ,_, raising_NN1 concerns_VVZ that_CST it_PPH1 will_VM discourage_VVI their_APPGE hiring_NN1 ._. 
"_" It_PPH1 will_VM affect_VVI their_APPGE decision_NN1 to_TO hire_VVI ,_, "_" said_VVD James_NP1 Gelfand_NP1 ,_, senior_JJ manager_NN1 of_IO health_NN1 policy_NN1 at_II the_AT U.S._NP1 Chamber_NN1 of_IO Commerce_NN1 ._. 
"_" If_CS they_PPHS2 need_VV0 to_TO hire_VVI a_AT1 janitor_NN1 or_CC a_AT1 salesclerk_NN1 ,_, in_II31 addition_II32 to_II33 paying_VVG them_PPHO2 $7_NNU an_AT1 hour_NNT1 ,_, they_PPHS2 're_VBR going_VVGK to_TO have_VHI to_TO assume_VVI they_PPHS2 will_VM have_VHI to_TO pay_VVI these_DD2 other_JJ costs_NN2 ._. "_" 
Other_JJ options_NN2 in_II the_AT Finance_NN1 Committee_NN1 document_NN1 include_VV0 imposing_VVG a_AT1 penalty_NN1 on_II employers_NN2 who_PNQS do_VD0 n't_XX offer_VVI insurance_NN1 ._. 
"_" The_AT Finance_NN1 bill_NN1 is_VBZ still_RR a_AT1 work_NN1 in_II progress_NN1 ,_, "_" said_VVD Frank_NP1 McArdle_NP1 ,_, who_PNQS heads_VVZ the_AT Washington_NP1 office_NN1 of_IO the_AT benefits_NN2 firm_JJ Hewitt_NP1 Associates_NN2 ._. 
"_" They_PPHS2 're_VBR trying_VVG to_TO find_VVI a_AT1 way_NN1 of_IO keeping_VVG employers_NN2 in_II the_AT game_NN1 of_IO providing_VVG health_NN1 care_NN1 coverage_NN1 without_IW having_VHG an_AT1 exodus_NN1 from_II employer_NN1 plans_NN2 ._. "_" 
INSURANCE_NN1 SUBSIDIES_NN2 To_TO lower_VVI the_AT cost_NN1 of_IO its_APPGE bill_NN1 ,_, the_AT Finance_NN1 Committee_NN1 is_VBZ ratcheting_VVG back_RP the_AT government_NN1 subsidies_NN2 that_CST would_VM be_VBI available_JJ to_II moderate-income_JJ families_NN2 and_CC older_JJR people_NN to_TO purchase_VVI insurance_NN1 in_II the_AT proposed_JJ exchanges_NN2 ._. 
Last_MD November_NPM1 ,_, Sen._NNB Max_NP1 Baucus_NP1 ,_, D-Mont._NP1 ,_, the_AT committee_NN1 's_GE chairman_NN1 ,_, recommended_VVD that_DD1 tax_NN1 credits_NN2 be_VBI provided_VVN to_II people_NN with_IW incomes_NN2 up_RG21 to_RG22 four_MC times_NNT2 the_AT federal_JJ poverty_NN1 level_NN1 ,_, or_CC $43,000_NNU for_IF individuals_NN2 and_CC $88,000_NNU for_IF a_AT1 family_NN1 of_IO four_MC ._. 
However_RR ,_, the_AT committee_NN1 's_GE draft_NN1 would_VM limit_VVI the_AT subsidies_NN2 to_II those_DD2 with_IW incomes_NN2 that_CST are_VBR no_AT more_DAR than_CSN three_MC times_NNT2 the_AT poverty_NN1 level_NN1 :_: single_JJ people_NN who_PNQS make_VV0 $33,000_NNU a_AT1 year_NNT1 and_CC families_NN2 that_CST earn_VV0 $66,000_NNU ._. 
The_AT House_NN1 Democrats_NN2 '_GE bill_NN1 also_RR would_VM limit_VVI the_AT subsidy_NN1 to_II those_DD2 with_IW incomes_NN2 at_II three_MC times_NNT2 the_AT poverty_NN1 line_NN1 ._. 
By_II lowering_VVG the_AT threshold_NN1 in_II that_DD1 manner_NN1 ,_, lawmakers_NN2 might_VM leave_VVI out_RP about_RG 4.6_MC million_NNO people_NN ,_, Urban_JJ Institute_NN1 researcher_NN1 John_NP1 F._NP1 Holahan_NP1 said_VVD ._. 
Three_MC times_NNT2 the_AT poverty_NN1 level_NN1 is_VBZ too_RG low_JJ ,_, said_VVD Judith_NP1 Solomon_NP1 ,_, a_AT1 senior_JJ fellow_NN1 in_II health_NN1 policy_NN1 at_II the_AT Center_NN1 on_II Budget_NN1 and_CC Policy_NN1 Priorities_NN2 ,_, a_AT1 policy_NN1 research_NN1 center_NN1 ._. 
"_" I_PPIS1 would_VM say_VVI the_AT top_JJ income_NN1 levels_NN2 for_IF the_AT subsidies_NN2 should_VM be_VBI set_VVN high_RR enough_RR to_TO make_VVI sure_JJ everyone_PN1 can_VM afford_VVI coverage_NN1 ._. "_" 
