Who are the 'old' cross-border workers affected by the health tax?

The term 'old' cross-border workers refers to those whose employment began before the new tax agreement between Switzerland and Italy came into force in mid-July 2023, with practical application starting from January 1, 2024.

Why does Ticino define the health tax as undue?

According to the legal opinion of Professor Pascal Hinny, the contribution must be classified as a tax. Since tax agreements grant Switzerland the sole right to tax the employment income of 'old' cross-border workers, the Italian levy would violate the convention against double taxation.

What are the next steps for the Ticino Council of State?

The Ticino government will consult the Federal Council in Bern to request support for the Canton's and Switzerland's position against the tax. Subsequently, the decision regarding financial compensation to Italy will be evaluated based on the development of this diplomatic and legal dispute.

Cross-border health tax: Ticino deems it undue (cross-border guide)

Di Valerie Linc · Published on 4 June 2026

The Ticino Council of State challenges the health tax for long-term cross-border workers, judging it contrary to double taxation agreements.

Context

In brief

The health tax is defined as undue by the Ticino State Council.
The issue concerns old cross-border workers subject to the new tax agreement.
The legal opinion by Prof. Hinny confirms the violation of international agreements.
The Ticino government will request the intervention of the Swiss Federal Council.

Key facts

What: Participation contribution to the National Health Service.
When: Application from January 2024 (agreement in force since July 2023).
Where: Italian border regions, impacting cross-border workers in Ticino.
Who: Ticino State Council and Prof. Pascal Hinny.
Status: Violation of tax and double taxation agreements.

The State Council of the Canton of Ticino has taken a firm stance regarding the controversial health tax introduced by Italy. The Ticino executive, after analyzing the regulatory framework, has defined this contribution as undue. The issue specifically concerns old cross-border workers, meaning those who began their employment before the entry into force of the new tax agreement between Bern and Rome, which occurred in mid-July 2023 with practical application starting from January 2024.

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Operational details

The analysis conducted by the Ticino authorities highlights a fundamental critical issue: the agreement on the taxation of cross-border workers establishes that only Switzerland has the right to levy taxes on the dependent work of so-called old cross-border workers. By identifying the health contribution as a tax in all respects, Professor Hinny's expertise dismantles the legal basis on which Italy would like to found this request. Without the 'cornerstone' of the right to taxation, the entire regulatory castle of the health tax collapses, rendering every claim null and void according to Swiss internal law and international conventions.

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Key points

The Ticino government has announced that, based on the expert report received, it will formally consult the Federal Council in Bern. The goal is to obtain full support from federal political authorities in the coming weeks, ensuring that the interests of Switzerland and the Canton of Ticino are strongly defended in the appropriate forums. Subsequently, a decision will be made regarding the payment of tax rebates to Italy, a step that will be closely linked to the resolution of this tax dispute. The State Council's strategy is to act on multiple levels: first through legal analysis, then through federal diplomatic channels, to nip the application of a tax deemed contra legem in the bud.

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Frequently Asked Questions

Who are the 'old' cross-border workers affected by the health tax?: The term 'old' cross-border workers refers to those whose employment began before the new tax agreement between Switzerland and Italy came into force in mid-July 2023, with practical application starting from January 1, 2024.
Why does Ticino define the health tax as undue?: According to the legal opinion of Professor Pascal Hinny, the contribution must be classified as a tax. Since tax agreements grant Switzerland the sole right to tax the employment income of 'old' cross-border workers, the Italian levy would violate the convention against double taxation.
What are the next steps for the Ticino Council of State?: The Ticino government will consult the Federal Council in Bern to request support for the Canton's and Switzerland's position against the tax. Subsequently, the decision regarding financial compensation to Italy will be evaluated based on the development of this diplomatic and legal dispute.