The Spiraling Cost of Federal Healthcare Subsidies and Carveouts
The US federal government faces several fiscal challenges in the coming decades, including the growing burden of federal healthcare programs and tax preferences.
14 min read
Expert
William McBride
Chief Economist & Stephen J. Entin Fellow in Economics
Dr. William McBride is the Chief Economist & Stephen J. Entin Fellow in Economics at the Tax Foundation, where he oversees major research projects primarily related to reforming the federal tax code, advancing sound tax policy, and improving the federal government’s fiscal outlook.
Dr. McBride has more than ten years of experience analyzing a variety of economic and policy issues. At the Tax Foundation he has served as the Vice President of Federal Tax Policy, leading our efforts to research, model, and reform the U.S. tax code, and as Chief Economist, researching the economics of taxation and guiding the development of the Tax Foundation dynamic scoring model. From 2015 to 2020 he was a manager in the National Economic and Statistics (NES) group at PwC where he worked on a wide array of projects including economic impact analyses, industry surveys, U.S. federal and state tax revenue estimates, and issues related to tax reform at the state, federal, and international levels.
Dr. McBride holds a PhD in economics from George Mason University, where he specialized in macroeconomics and agent-based modeling. His research has been cited by policymakers, quoted by major media outlets, including The Wall Street Journal and The New York Times, and published in scholarly journals, such as the National Tax Journal, Public Budgeting & Finance, and Tax Notes.
Latest Work
A Competitive Corporate Tax Code is Key to Sustaining Strong Economic Growth
The 12-year history of Tax Foundation’s ITCI shows that tax policy is constantly in flux around the world and that tax policy design choices matter for economic growth.
5 min read
Blog
Short FormWhat 250 Years of Tax History Reveal About the US Tax Code
Just as many parts of American life have transformed over the past 250 years, so too has the federal tax system. While most taxes levied in the 18th century are still levied in some form today, the federal government’s reliance on them, the complexity of the tax code, and Americans’ overall tax burdens have shifted considerably.
5 min read
Don’t Blame the Messenger—the CBO—for Our Current Fiscal Problems
Publicly held debt is projected to rise to a new record high of 106 percent of GDP within the next four years and continue to rise to 120 percent by 2036 and 175 percent by 2056.
8 min read
Can Tax Reform Solve the Debt Problem—or Just Slow It?
This study simulates several large tax increases and consistently finds that even tax increases large enough to close the primary deficit in the near term will lose ground over time and fail to put the debt on a sustainable course.
41 min read
Tax Treatment of the Pass-Through Business Sector: A Primer
The pass-through business sector—including partnerships, S corporations, and sole proprietorships—employs most of the private-sector workforce in the US and accounts for about half of US business income.
34 min read
Will the OBBBA Tax Cuts Grow the US Economy?
Over the long run, OBBBA’s permanent extension of lower marginal tax rates on work, saving, and investment lays a solid foundation for stronger economic growth.
6 min read
How Does the OBBBA Impact Debt, Deficits, and Tax Revenue?
Our modeling indicates the One Big Beautiful Bill Act (OBBBA) will boost economic growth but increase deficits, leading to record high debt in 2028 that rises to 124 percent of GDP by 2034.
7 min read
The Chronic Disorder of Ever-Expanding Healthcare Subsidies
Amidst a government shutdown, healthcare subsidies have metastasized into a major threat to the nation’s fiscal and economic health.
The Unaffordable Healthcare Subsidies That Led to a Government Shutdown
The fiscal fight that resulted in the current federal government shutdown is, at its core, about the healthcare sector, spiraling healthcare costs, and federal subsidies.
7 min read
Federal Revenue and Distributional Impacts of Limiting the Tax Exclusion for Employer-Sponsored Health Insurance Premiums
Policymakers are considering ways to extend the enhancements made to Affordable Care Act premium tax credits that expire at the end of the year, which could cost $350 billion over the next decade. Any expansion of the credits should be offset by reducing other healthcare subsidies or preferences in the tax code, the largest of which is the exclusion for employer-sponsored health insurance (ESI) premiums, estimated to cost more than $5 trillion over the next decade due to reduced income and payroll tax revenue.
10 min read
Blog
Short FormUnderstanding Debt, Deficits, and Interest
The US national debt is on an unprecedented and unsustainable trajectory that will require ever-greater borrowing and larger interest payments on what is borrowed. These interest payments will, in turn, consume a larger part of the budget, and all Americans will pay the price.
4 min read
Does the G7 Global Minimum Tax “Side-by-Side” Solution Give US Multinationals an Advantage?
Rather than returning to a world of retaliatory tax measures and transatlantic disputes, the OECD should continue to decrease the compliance costs of Pillar Two by simplifying the rules to reduce any possible risk that the US has a compliance cost advantage and working with G7 countries on a side-by-side solution.
6 min read
Blog
Short FormThe Progressivity of the US Tax Code
Since the inception of the modern federal individual income tax in 1913, the US tax code has generally become more progressive, not less. Will the recent tax changes made by the One Big Beautiful Bill Act (OBBBA) alter this?
4 min read
The Trump Administration is Building a Fiscal House of Cards
President Donald Trump’s fixation on tariffs as a solution for just about everything, including the deficit, has led him to run roughshod over the law and norms of international trade.
US Effective Tax Rates Remain Highly Progressive, Despite Some Economists’ Claims
Targeting wealth at the top through higher taxes has a certain appeal, but it also comes with a lot of drawbacks, including increased avoidance and reduced incentives to invest.
6 min read
The Good, the Bad, and the Ugly in the One Big Beautiful Bill Act
The One Big Beautiful Bill Act makes many of the individual tax cuts and reforms of the TCJA permanent. It improves upon the TCJA by making expensing for R&D and equipment permanent. However, for the most part, it does not include further structural reforms, and instead introduces many new, narrow tax breaks to the code, adding complexity and raising revenue costs.
7 min read
Budget Reconciliation: Tracking the 2025 Trump Tax Cuts
President Trump signed the One Big Beautiful Bill Act into law on July 4, 2025.
18 min read
Big, Beautiful Bill Will Raise Both Growth and Deficits
We are living in an age of hyperbole, or as writer Matthew Hennessey calls it, the “Age of Excusability,” in which our politicians succeed by making outlandish claims. So it goes with the One Big Beautiful Bill, which will usher in a new golden age or send us down the tubes for good, depending on your sources.
Will the Big Beautiful Bill Lead to an Economic Boom or Just Modestly Higher Growth?
Lawmakers are right to be concerned about deficits and economic growth. The best path to address those concerns is to ensure OBBB provides permanent full expensing of capital investment, avoids inefficient tax cuts, and offsets remaining revenue losses by closing tax loopholes and reducing spending.
8 min read