Greg Mankiw on the implicit marginal tax rates in the whatchamacallit that passed out of the Senate Finance Committee.
By the conventions of budget scoring, CBO ignores these macroeconomic changes. By contrast, households facing increases in marginal tax rates of 20 percentage points will not ignore them. This means that the healthcare reform bill will likely have a more adverse budgetary impact than CBO estimates.
Roy already noted another tax hike on working families who pay for care.