The Swiss Times - Swiss News in English

New health tax for cross-border commuters meets with resistance

Cross-border commuters working in southern Switzerland must now pay a health tax to Italy. This is intended to keep workers in their own country. Under pressure from the Ticino Industry Association, the Federal Council is now dealing with the tax.

The health tax introduced by Italy at the beginning of the year is being "examined in depth" by Bern, according to the response from the head of the Federal Department of Finance, Karin Keller-Sutter, and the Minister of Foreign Affairs, Ignazio Cassis.

Should the new levy contradict the bilateral international agreements between Switzerland and Italy, the Swiss embassy in Rome will intervene with the relevant ministries, the letter continues.

The new article is part of the Italian Budget Law 2024 and stipulates that cross-border commuters pay between 3% and 6% of their net salary to the Italian healthcare system. This is intended to finance bonuses for Italian healthcare staff and limit migration from the border regions of Lombardy and Piedmont to Switzerland.

Criticism from the trade unions

The trade unions oppose the health levy. This is "unlawful", as the article of the law introduces a mechanism of double taxation, although the tax agreement between Switzerland and Italy expressly prohibits this.

In its letter sent to Bern, the Ticino industry association AITI argues along the same lines: the levy is essentially a tax, and Italy cannot levy such a tax as the tax rules are laid down in the new agreement on cross-border commuters.

The Swiss trade unions are also critical of the tax. A petition has been launched on calling for the abolition of the health tax. By January 31, 10,972 signatures had been collected.

The new health tax affects "old" cross-border commuters, i.e. those who started working in Switzerland before July 17 of last year.

According to the cross-border commuter agreement that came into force last July, Switzerland retains 80% of the withholding tax levied on the income of Italian cross-border commuters. The new cross-border commuters are also taxed properly in their country of residence, and this is intended to eliminate double taxation.

Almost 80,000 Italian workers cross the Swiss border into the canton of Ticino every day. The majority of them come from Lombardy.


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