Lombardy demands health tax alignment, Piedmont says no

Context

In brief

• Regional council in Lombardy: clash over the cross-border workers' health tax
• Piedmont reiterates its opposition, creating a regulatory misalignment

The turbulent session of the regional council in Lombardy brought the controversial health tax back to the centre of attention.

The so-called health tax is the contribution to the Italian National Health Service set by Law 213/2023 (Art. 1, paragraphs 237-239): from 3% to 6% of the net salary earned in Switzerland, with a minimum of 30 and a maximum of 200 euros for each month worked, set each year by the region of residence.

This measure has sparked various reactions, with the Pd, through councilor Angelo Orsenigo, reiterating the absolute opposition and illegitimacy of the rule. Marco Contessa, national responsible for cross-border workers for the Cisl, underlined how this measure could create tensions between cross-border workers and healthcare personnel.

The situation further complicates with Piedmont's position, which has repeatedly stated, through the undersecretary to the presidency of Piedmont Region Alberto Preioni, not to want to apply such a rule. Despite the recall of the regional councilor of Fratelli d'Italia Giacomo Zamperini, who underlined how it would be unacceptable for other regions such as Piedmont not to apply it, Preioni reiterated Piedmont's opposition. 'We remain firm on our decision and are not making further assessments. We will not apply it,' Preioni declared, adding that Lombardy's position will require further compliance.

Operational details

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Key points

Source: comozero.it

Article 1(237–238) of Italian Law No. 213/2023 does not apply indiscriminately to all cross-border workers. It covers: (a) Italian residents who work and stay in Switzerland and use the Italian SSN; (b) frontier workers under Article 9(1) of the Italy–Switzerland Agreement whose income is taxable only in Switzerland and who exercised the legal right to choose health insurance; and (c) dependants of those two categories. Paragraph 238 sets a progressive 3–6% share of net Swiss salary, with a €30 minimum and an ordinary €200 maximum for each month worked from 2024. The cap may be doubled in cases of omitted payment or omitted communication specified in Article 1(100) of Law No. 207/2024. The Region of residence sets the rates and procedure each year.

Why the regional comparison matters

The article compares the position reported in Lombardy with the refusal expressed by Piedmont. These are political positions, not two personalised calculations and not proof that the rule is already applied in the same way everywhere. For a cross-border worker, the region of residence remains decisive together with national law and any implementing measures. The reported disagreement explains the uncertainty but cannot establish an individual amount.