What could be the impact of the health tax on the economic sectors most dependent on cross-border commuters in Switzerland?

The tax could negatively affect competitiveness, especially in the technology, logistics and service sectors, where cross-border commuters are numerous. This could lead to increased costs for employers, who could look for alternatives such as hiring workers residing in Switzerland.

How exactly is the health tax for cross-border commuters calculated?

The health tax, provided for by Law 213/2023, consists of a contribution to the National Health Service calculated between 3% and 6% of the net salary received in Switzerland. The monthly amount is subject to precise limits: it cannot be less than 30 euros nor more than 200 euros for each month worked. The specific rate is defined annually by the region of residence of the worker.

Will Lombardy apply the health tax to cross-border commuters?

Currently, the situation is uncertain. Giacomo Zamperini, president of the Special Commission for relations between Lombardy and the Swiss Confederation, said that Lombardy could decide not to apply the tax if the other Italian regions involved do not proceed in the same direction. The final decision will therefore depend on coordination between the different Italian regional administrations in the coming weeks.

What are the regulatory references that introduce the health tax for cross-border commuters?

The introduction of the health tax is governed by Law 213 of 30 December 2023. Specifically, paragraphs 237 to 239 of Article 1 establish the methods of participation in the National Health Service for cross-border workers, defining the percentages of levy on the net salary and the minimum and maximum brackets applicable monthly.

What can I do to track the impact of the health tax on my salary?

To manage uncertainty, it is advisable to constantly monitor official announcements from regional authorities and participate in public meetings or trade forums. It is also advisable to use online calculation tools to simulate the economic impact of the deduction on one's net salary, bearing in mind that the legislation provides for a maximum ceiling of 200 euros per month, regardless of the income received.

Health Tax: Will Lombardy Not Apply the Contribution?

By Laura Bianchi (editorial byline of the newsroom, AI-generated text) · Published on 6 March 2026 · Updated on 1 November 2026

Panoramic view of Lake Lugano with mountains in the background.

Giacomo Zamperini clarifies that if other regions do not apply the health tax, Lombardy will follow the same example.

Context

TL;DR

Lombardy may not apply health tax if other regions don't
Tax could impact job competitiveness in Switzerland

The issue of the health tax for cross-border workers has reopened a lively debate between the Italian regions and the Canton of Ticino. Recently, Giacomo Zamperini, a regional councilor of Fratelli d'Italia and president of the Special Commission for Relations between Lombardy and the Swiss Confederation, stated that "If other regions do not apply the health tax, Lombardy will not do so either." This comment comes at a time of uncertainty and heated discussions regarding the introduction of a health contribution for historical cross-border workers.

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.

Lombardy, being one of the regions most affected by the presence of cross-border workers, is at the center of this debate.

In conclusion, the debate on the health tax remains open, with an urgent need for clear communication between Italian and Swiss authorities to find solutions that can ensure a balance between fiscal needs and economic sustainability for cross-border workers. The coming weeks will be decisive in understanding the real intentions of the regions involved and the potential repercussions on the thousands of workers who cross the border daily.

Operational details

The implementation of this tax may vary from region to region, with Zamperini indicating that Lombardy might refrain from applying the tax if other regions do not follow suit. This creates a climate of uncertainty among cross-border workers, who fear that their living conditions may undergo unfavorable changes.

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.

Useful tools to protect your net income

To reduce FX leakage, compare CHF-EUR exchange options and banks for cross-border workers.

Key points

For cross-border workers concerned about the introduction of the health tax, it is essential to stay informed and prepared. Some practical advice includes:

1. Monitor legislative developments: Stay updated on official announcements from Lombardy and Ticino institutions.

2. Participate in public meetings: It is helpful to attend forums and public meetings.

3. Use online tools: Calculating the economic impact of the tax on one's salary is crucial.

Frequently Asked Questions

What could be the impact of the health tax on the economic sectors most dependent on cross-border commuters in Switzerland?: The tax could negatively affect competitiveness, especially in the technology, logistics and service sectors, where cross-border commuters are numerous. This could lead to increased costs for employers, who could look for alternatives such as hiring workers residing in Switzerland.
How exactly is the health tax for cross-border commuters calculated?: The health tax, provided for by Law 213/2023, consists of a contribution to the National Health Service calculated between 3% and 6% of the net salary received in Switzerland. The monthly amount is subject to precise limits: it cannot be less than 30 euros nor more than 200 euros for each month worked. The specific rate is defined annually by the region of residence of the worker.
Will Lombardy apply the health tax to cross-border commuters?: Currently, the situation is uncertain. Giacomo Zamperini, president of the Special Commission for relations between Lombardy and the Swiss Confederation, said that Lombardy could decide not to apply the tax if the other Italian regions involved do not proceed in the same direction. The final decision will therefore depend on coordination between the different Italian regional administrations in the coming weeks.
What are the regulatory references that introduce the health tax for cross-border commuters?: The introduction of the health tax is governed by Law 213 of 30 December 2023. Specifically, paragraphs 237 to 239 of Article 1 establish the methods of participation in the National Health Service for cross-border workers, defining the percentages of levy on the net salary and the minimum and maximum brackets applicable monthly.
What can I do to track the impact of the health tax on my salary?: To manage uncertainty, it is advisable to constantly monitor official announcements from regional authorities and participate in public meetings or trade forums. It is also advisable to use online calculation tools to simulate the economic impact of the deduction on one's net salary, bearing in mind that the legislation provides for a maximum ceiling of 200 euros per month, regardless of the income received.