In an all-day, closed-door meeting today, lawmakers are discussing policy options for financing health-care reform. A Senate Finance Committee document circulated before the meeting makes for some odd reading; it’s a hodge-podge of proposals for savings within the current health-care system cobbled together with a bunch of health-care-related and “lifestyle-related” revenue raisers.

If your organization offers a health plan or makes contributions to employees’ health savings accounts — or if you happen to like sodas — you might want to take a look at what the senators have in mind.

Options to modify the tax exclusion for employer-sponsored health insurance are firmly on the agenda, as I blogged here. At $132.7 billion in 2008, this is far and away the biggest health-related tax break currently targeted for revision, according to the 40-page Finance Committee report. The document envisages several options for squeezing this potential revenue source, including limiting the exclusion for taxpayers with adjusted gross incomes of over $200,000 ($400,000 for joint filers).

The senators also propose some modifications to health savings accounts (HSAs) — doubtless another nail in the coffin of consumer-directed health care. Currently, you can pull money out of an HSA for some trivial nonmedical reason — like, oh, let’s say you lost your job, or you’re in danger of losing your house in foreclosure — but you’ll pay income tax on it, and a punitive 10 percent on top of that. One option currently under discussion would increase the penalty to 20 percent.

Flexible spending accounts, the popular use-it-or-lose-it health-care expense reimbursement programs offered by many employers, may be headed for extinction. The lawmakers will consider limiting the amount that can be contributed to FSAs or eliminating them altogether.

Among a ragbag of other health-related revenue raisers, one that stands out, for me at least (kids in college), is a proposal to end the FICA exemption for students employed by colleges and universities. The senators are gunning for teaching hospitals here, claiming that these institutions have applied the exemption inappropriately to medical residents receiving stipends.

And then, of course, there are those “lifestyle-related” schemes, including the inevitable call for an increase in the excise tax on booze. And the lawmakers certainly don’t neglect the sin-tax target du jour: “sugar-sweetened beverages” (aka sodas, but also fruit and vegetable drinks, energy and sports drinks, and iced teas and coffees), now to be subject to a brand new federal excise tax.

Can a hamburger tax be far behind? ###