Rome changes health tax proposal for former cross-border workers

Context

TL;DR

• Rome changes the proposal before its implementation
• The contribution would become fixed: 30-150 euros per month
• The amount would be set every year by the Region
• Ticino keeps just over 50 million frozen

Proposal → 2027 budget bill proposal Recipients → old cross-border workers in Italian border regions Amount → between 30 and 150 euros per month Calculation → fixed amount, not linked to Swiss salary Decision → Region of residence, every year Status → draft text

Rome wants to change the rules of the so-called health tax before even applying it. The change emerged on Monday from the draft of the 2027 budget bill and concerns a contribution that has existed since 2024.

State Councillor Christian Vitta comments on the Italian proposal and sees the change in approach as confirmation of the objections raised by Canton Ticino in recent months. The Ticino Government considers the criticism directed at the previous version to be well-founded.

Christian Vitta considers the change in the rules of the health tax confirmation of the validity of the positions supported by Canton Ticino in recent months: otherwise, it would be unclear why to intervene on a measure that has not yet been applied.

The change in the draft

The contribution concerns the so-called old cross-border workers: people who live in the Italian border regions and are taxed only in Switzerland. The amount is used to finance the Italian National Health Service.

The levy provided for under the current regulations is proportional to the Swiss salary, although the Regions have not applied it so far. In the draft, the criterion changes: the amount would be fixed, between 30 and 150 euros per month, and would be set every year by the Region in which one resides.

The director of the Department of Finance and Economy prefers not to comment on the details of the formula for now. For Canton Ticino, the issue is political: the tax would arrive shortly after the signing of an agreement between Switzerland and Italy, affecting a regulatory framework that has not yet been applied. The text is still a draft, and there is no indication that Parliament has made a final decision.

Operational details

From salary to a fixed amount

The difference between the two versions can be seen in the basis for the levy. Today, in the wording challenged by the Canton of Ticino, the amount depends proportionally on the Swiss salary; in the draft linked to the 2027 budget, the reference to salary disappears and a monthly range between 30 and 150 euros remains. The source does not indicate how the Region would choose the value within the range, nor what criteria it would use to set it each year.

The report refers to the so-called old cross-border workers. They are workers who live in the Italian border regions and who, for employment income, are taxed in Switzerland (for new cross-border workers, also in Italy, with a tax credit). From a tax perspective, Swiss withholding on employment income is a withholding tax. The healthcare contribution, by contrast, is presented as an amount intended for Italy’s National Health Service.

This distinction helps avoid confusing the healthcare levy with ordinary taxation of salary. It is precisely the addition of a further amount that fuels the objection raised by Cristian Bisa, of the Unione frontalieri italiani in Svizzera. For the trade unionist, changing the name does not change the substance: in his view, the request remains double taxation imposed on workers. The source also reports his objection concerning the service: it is decided how much and how to collect, but it is not indicated what would be offered to the worker in return.

The political link indicated by Vitta is the agreement between Switzerland and Italy signed a short time ago. The source does not specify its contents or articles and does not explain how the new contribution would be coordinated with that agreement. The official legal reference for the agreement on cross-border workers is available in the New Cross-Border Workers Agreement – Law 83/2023. The documented point in the article, however, remains the choice to propose a new tax after the agreement was signed, not the legal outcome of its review.

Key points

Refurbishments and technical table

The question of the health tax does not change the Canton Ticino's route on refreshments. In June, the State Council blocked a part of the sums destined for Lombardy, a choice that the Federal Council had not shared.

Subsequently, Bern opened a working table with Rome involving the Lombardy Region and Canton Ticino. In the meantime, the funds remain blocked. Christian Vitta quantifies the frozen sum at just over 50 million and says that the Canton is ready to unlock it as soon as the technical table has completed its work.

The draft and the required verifications

On the revenue from the health tax, Vitta's position is clear: it is not good that everything goes to the Italian State; something, according to the Councilor of State, must also remain in the cantonal territory. It is a separate request from the monthly mechanism of the draft, because it concerns the destination of the revenue and not the way in which the amount is calculated.

Cristian Bisa maintains a principled critique. According to the representative of the Italian Border Union in Switzerland, a tax should correspond to a service. The text discussed, on the other hand, defines how much to withdraw and how to do it, while it does not indicate what would be done for the worker. The trade unionist therefore considers the simple change of words insufficient.

The procedure has not yet reached the final point: the text is a draft and the unions will ask for verification before approval. If Parliament gives the green light, they have announced that they will turn to the Public Prosecutor's Office. The source does not indicate the date of any vote or the outcome of the verification, so it does not yet document the application of the contribution or the date of a first payment.

As a separate official reference on the SSN fee, said health tax, is available on DM Salute 14/11/2025. For refreshments chapter updates, see Ticino-Italy tax rebates.

Source: rsi.ch