Debate over health reform's insurance tax heats up

Medicare actuary Rick Foster has testified that the law will increase national health expenditures by $311 billion through 2019. But the administration says Foster undervalues cost-containment measures and that many Americans will still save money thanks to the federal subsidies they'll be entitled to in 2014.

The new estimate comes as health insurance trade associations are again drawing attention to the tax after focusing much of their efforts for the past year on the law's implementation.

"We've really had our hands full just making all the considerable changes," said Alissa Fox, senior vice president of policy and representation with the Blue Cross Blue Shield Association. "This tax is going to add hundreds of dollars to the cost of insurance for individuals and small employers. And that's something we are raising concerns with."

Karen Ignagni, president and CEO of America's Health Insurance Plans, called it an "unprecedented" tax that would "hit individuals and small business."

"That moves in the wrong direction, because anything that increases cost beginning in 2014 is going to be something that individuals and small employers look at very very carefully and are going to be concerned about," she told The Hill. "We're talking about (the tax and other provisions) again now so people (in Congress) can examine the issues between now and 14 and make changes for this to work, basically."