Health Insurance Tax (HIT)

Woman visiting the doctor

The health insurance industry faced several unique threats as the result of health care reform around the passage of the Affordable Care Act. One of the highest priority issues was related to the government’s ability to charge new annual fees on insurance companies for the health insurance premiums they provide.  

Our team worked with business leaders, political advocates, and health insurance professionals to stop the implementation of the Health Insurance Tax (HIT). The Health Insurance Tax was a proposed surcharge on health insurance premiums that formed into the threat of a multi-billion dollar tax imposed on workers, seniors, small businesses, and Medicare and Medicaid beneficiaries. 

Strategic Elements serves as field representatives on a multitude of health care reform issues in states throughout the country. The Health Insurance Tax emerged as key policy priority for the health insurance industry in 2019 and the opportunity existed to permanently stop the legislation from being implemented. Bipartisan support to end the Health Insurance Tax was required in order to accomplish a full repeal in Congress. While the Health Insurance Tax was not currently in effect at that time, without action in Congress, the tax would have taken effect at the start of 2020. 

Our task was to recruit and activate high-level, grasstops stakeholders to increase public awareness and drive direct support from members of Congress to support a full repeal of the Health Insurance Tax. Strategic Elements is responsible for building bipartisan support in Iowa, Colorado, and Nevada. 

Contacts to Members of Congress 

  • Recruited key voices for legislative targets and drafted and deployed customized, tailored messages to members of Congress, talking about the specific impacts of Health Insurance Tax on business, individuals, and the health insurance system. 
  • Message delivery to Congress included: 
    • Calls to members of Congress 
    • Individual and joint letters 
    • Coordinated intercepts 

Earned Media and Social Media 

  • Developed and pitched editorials from top recruited advocates in target districts 
  • Executed on social media by recruiting advocates to post about the Health Insurance Tax on their social channels and tag their representatives 


Progress was benchmarked by weekly field reports, and the list of bill co-sponsors (to repeal the HIT) was also tracked in real-time, as were member responses from stakeholder contacts. Our efforts, combined with the impact of the stakeholders and advocates we recruited, helped bring new members of Congress into the fold and supported repealing the Health Insurance Tax altogether. Our efforts displayed the wide-ranging impact of the Health Insurance Tax on businesses, small business owners, and a number of sectors. 

As a result of persistent efforts, new sponsors of the bill to repeal the Health Insurance Tax were secured from both parties. Bipartisan efforts led to a final repeal of the Health Insurance Tax in Congress in late 2019.  

Co-sponsors Secured: 

  • Iowa Rep: Cindy Axne (D) 
  • Colorado Rep: Scott Tipton (R) Doug Lamborn (R) 
  • Nevada Rep: Mark Amodei (R) 

Grasstops Engagement 

  • 28 Members of Congress Contacts 
  • 5 Earned Media Hits 
  • 25 Social Media Posts 
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