How can I calculate the impact of the health tax on my salary?

Use the [cross-border worker salary calculator](nav:calculator) from Frontaliere Ticino, which takes into account current regulations and possible changes related to the 'health tax'. The tool automatically updates the tax amount based on the 2026 legislation.

What should I do if I work in Ticino but live in Lombardy?

If you are an 'old' cross-border worker (hired before 2020), taxation is exclusive to Switzerland and you are not directly affected by the law. However, keep an eye on official communications from the Lombardy Region to check for any changes in local public services, which could be impacted by retaliatory measures on reimbursements.

Cross-border health tax: Lombardy stands alone, Ticino threatens retaliation

Di Valerie Linc · 10 April 2026, 20:56

Lombardy is the only Italian region pushing for the implementation of the 'cross-border health tax' for frontier workers, which came into force 27 months ago but has never been applied. The Canton of Ticino has threatened to reduce reimbursements in response.

Contesto

On Tuesday, April 14, the Lombardy Regional Council will discuss a motion introduced by Democratic Party councillors Samuele Astuti and Angelo Orsenigo. The goal is to urge the Italian government to repeal the 'health tax' for cross-border workers, a levy introduced in the 2021 budget but never enforced. Giuseppe Augurusa, national coordinator for cross-border workers at the CGIL trade union, has bluntly described the tax as a violation of international law: > 'What the legislator calls a 'contribution' is, in fact, a tax and breaches the 2020 Italy-Switzerland agreement, which became law in 2023.' According to the CGIL, 'old' cross-border workers already under a transitional regime should be taxed exclusively in the country where they work, namely Switzerland. ## The 2020 agreement and its repercussions The agreement signed on December 23, 2020, and ratified in 2023 clearly states that cross-border workers' income is subject to taxation solely in the state where the work is performed. The Italian government’s plan to introduce an additional levy on income already taxed at source, without any link to individual services provided, represents, in the CGIL’s view, a direct violation of the agreement. > 'If enforced, the law would inevitably end up before the Constitutional Court,' Augurusa warned. The union’s stance has been reiterated ahead of the Lombardy Regional Council debate, where the PD’s motion could mark a turning point. ### Reactions from the Canton of Ticino Ticino officials have already labelled the tax as contrary to the double taxation agreement. The threat of retaliatory measures concerns reimbursements—transfers Switzerland pays to Italian border municipalities under tax agreements. A reduction in these funds would impact around 400 municipalities, jeopa...

Dettagli operativi

The failure to implement the 'health tax' for over two years has created a regulatory limbo that exposes cross-border workers to daily uncertainties. According to available data, around 60,000 cross-border workers travel between Lombardy and Ticino every day, with peaks recorded at the Brogeda and Gaggiolo crossings. For many of them, the current situation translates into a double uncertainty: tax-related, due to the unenforced rule, and employment-related, as potential retaliatory measures on reimbursements could impact local public services. ### What changes for 'old' and 'new' cross-border workers Cross-border workers are divided into two categories: 'old' and 'new'. The former, already in a transitional arrangement at the time of the 2020 agreement, have the certainty of exclusive taxation in Switzerland. The latter, hired after 2020, are subject to different rules and could be directly affected by any retaliatory measures. 'A worker hired in Lugano in 2021 could find themselves barred from using public health services in Lombardy if Switzerland decided to reduce reimbursements,' explained an official from the Federal Finance Office in Bern. ### Possible scenarios Two main scenarios are emerging: the first involves Lombardy abolishing the rule, thus avoiding a legal dispute with Switzerland. The second, riskier scenario, would entail the tax being applied and Switzerland responding accordingly. In this case, Lombard municipalities could lose up to 15% of current reimbursements, with an estimated reduction of between 50 and 100 million euros annually. 'This would lead to immediate cuts to services such as road maintenance and basic healthcare,' stated a mayor from the province of Varese. ### The role of the federal government The government in Bern, a signatory to...

Punti chiave

For cross-border workers and the municipalities concerned, the discussion in the Lombardy Regional Council on Tuesday, April 14, represents a crucial moment. Here’s what to do to prepare for possible scenarios. ### Step 1: Verify your category Cross-border workers must distinguish between: - 'Old' cross-border workers: hired before 2020, subject to exclusive taxation in Switzerland. - 'New' cross-border workers: hired after 2020, potentially affected by retaliatory measures. You can check your category on your payslip or by contacting the tax office of your municipality of residence in Lombardy. ### Step 2: Monitor official communications The Lombardy Region will publish the outcomes of the PD motion on its institutional channels. Workers can subscribe to the newsletters of border municipalities (Varese, Como, Lecco) to receive timely updates. The Ticino DFE will update its dedicated page for cross-border workers if there are changes to access to public health services. ### Step 3: Assess the impact on healthcare services In the event of reductions to refunds, cross-border workers may face: - Higher costs for private healthcare services in Lombardy. - A reduction in the availability of public healthcare services in border municipalities. - Increased fees for daycare and public transport. To assess the risk, it is advisable to consult your municipality of residence or the Swiss Federal Office of Public Health to verify access to public healthcare services in case of reduced refunds. ### Step 4: Download useful tools To calculate the current tax impact and simulate future scenarios, we recommend using the cross-border worker salary calculator by Frontaliere Ticino. This tool, updated as of 2026, takes into account current regulations and potential changes related to...

Punti chiave

{"q":"Is the 'health tax' for cross-border workers already in force in Lombardy?","a":"No. The law came into effect 27 months ago, but it has never been applied. The debate in the Lombardy Regional Council on April 14, 2026 could lead to its repeal or the initiation of procedures for its implementation."},{"q":"How can I check if I am an 'old' or 'new' cross-border worker?","a":"The 'old' cross-border workers are those hired before December 23, 2020 (the date of the Italo-Swiss agreement). The 'new' ones were hired after this date and could be directly affected by any retaliatory measures on reimbursements. You can verify this by checking the hiring date on your payslip or by contacting the tax office of your municipality of residence in Lombardy."},{"q":"What are reimbursements and why are they at risk?","a":"Reimbursements are the funds Switzerland pays to Italian border municipalities under tax agreements. A reduction in reimbursements would affect around 400 municipalities, jeopardizing essential services like kindergartens, public transport, and road maintenance. A possible cut is estimated between 5% and 15% of the current amount, equivalent to 50 to 100 million euros per year."},{"q":"What happens if Lombardy applies the health tax?","a":"According to the CGIL, the law would violate the 2020 Italo-Swiss agreement and end up before the Constitutional Court. Meanwhile, Switzerland threatens retaliatory measures on reimbursements, potentially leading to cuts in public services in border municipalities."},{"q":"Where can I find official updates on the situation?","a":"The Lombardy Region will publish the outcomes of the PD motion on its official channels. Border municipalities (Varese, Como, Lecco) will update their dedicated pages for cross-border workers. The Ticin...

Frequently Asked Questions

Is the 'health tax' for cross-border workers already in force in Lombardy?: No. The law came into effect 27 months ago, but it has never been applied. The debate in the Lombardy Regional Council on April 14, 2026 could lead to its repeal or the initiation of procedures for its implementation.
How can I check if I am an 'old' or 'new' cross-border worker?: The 'old' cross-border workers are those hired before December 23, 2020 (the date of the Italo-Swiss agreement). The 'new' ones were hired after this date and could be directly affected by any retaliatory measures on reimbursements. You can verify this by checking the hiring date on your payslip or by contacting the tax office of your municipality of residence in Lombardy.
What are reimbursements and why are they at risk?: Reimbursements are the funds Switzerland pays to Italian border municipalities under tax agreements. A reduction in reimbursements would affect around 400 municipalities, jeopardizing essential services like kindergartens, public transport, and road maintenance. A possible cut is estimated between 5% and 15% of the current amount, equivalent to 50 to 100 million euros per year.
What happens if Lombardy applies the health tax?: According to the CGIL, the law would violate the 2020 Italo-Swiss agreement and end up before the Constitutional Court. Meanwhile, Switzerland threatens retaliatory measures on reimbursements, potentially leading to cuts in public services in border municipalities.
Where can I find official updates on the situation?: The Lombardy Region will publish the outcomes of the PD motion on its official channels. Border municipalities (Varese, Como, Lecco) will update their dedicated pages for cross-border workers. The Ticino Department of Finance and Economics (DFE) will provide updated guidance on the page dedicated to cross-border workers.
How can I calculate the impact of the health tax on my salary?: Use the [cross-border worker salary calculator](nav:calculator) from Frontaliere Ticino, which takes into account current regulations and possible changes related to the 'health tax'. The tool automatically updates the tax amount based on the 2026 legislation.
What should I do if I work in Ticino but live in Lombardy?: If you are an 'old' cross-border worker (hired before 2020), taxation is exclusive to Switzerland and you are not directly affected by the law. However, keep an eye on official communications from the Lombardy Region to check for any changes in local public services, which could be impacted by retaliatory measures on reimbursements.