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Medical device tax opponents’ $29 billion question

Plenty of people in Washington want to get rid of the tax. They just need to figure out how to pay for it.

With the GOP takeover of Congress, action on a device tax repeal is coming sooner rather than later.
REUTERS/Jonathan Ernst
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Rep. Erik Paulsen
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• First, Paulsen’s bill could pass on its own, with an agreed-upon offset. Mark McClellan, a health care expert at the Brookings Institution, suggested, as Kind did, that lawmakers could look toward other aspects of federal health care spending for savings, even within the ACA.

• Lawmakers could also attach a repeal bill to a broader tax reform package. But modern attempts at so-called “comprehensive tax reform” have turned out to be the legislative equivalent of Bigfoot: much discussed, often sought after, rarely seen in the wild and, until evidence proves otherwise, probably a myth.

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• McClellan suggested lawmakers could pass a repeal bill annually, with some kind of spending offset attached each time (in other words, finding about $3 billion a year, rather than $29 billion all at once). Congress does this with the “doc-fix,” a yearly exercise in which Congress delays Medicare reimbursement cuts to doctors.