Frontierers, health tax: "A bomb behind a handful of change" (cross-border guide)

Context

On February 19, 2026, the parent company of "Civic Action for Luino and Fractions" and minority counsel, lawyer Furio Artoni, sent a press release regarding relations between Italy and Switzerland on the issue of border workers and the so-called health tax. According to the announcement, the New Frontier Agreement, in force since 1 January 2024, was signed on 23 December 2020.

The New Frontier Agreement was signed by Italy and Switzerland to regulate relations between Italian citizens working in Switzerland and their employers. Among the main innovations introduced, there is the so-called "health tax", which has been applied since 1 January 2024.

The health tax was introduced to cover the health expenses of border workers, who can request medical treatment in Switzerland. The cost of the tax varies according to the border crossers' region of residence. In Ticino, for example, the health tax was set at CHF 200 (about EUR 190) per year for border workers with an income of less than CHF 40,000 (about EUR 38,000) per year. In Valais, on the other hand, the health tax was set at 250 CHF (about 240 EUR) per year for border workers with an income of less than 40,000 CHF (about 38,000 EUR) per year.

The health tax has been applied to all border crossers who have an income of less than CHF 40,000 (approximately EUR 38,000) per year. Border crossers with an income of more than CHF 40,000 (approximately EUR 38,000) per year

Operational details

The health tax, imposed on frontier workers in the form of a monthly contribution varying from thirty to two hundred euros, was from the beginning what the writer publicly denounced: a legal abomination. I was the first – still urges Artoni –, at the local institutional level, to point out its inconsistency not only politically but structurally legal – an unconstitutional levy, incompatible with the international treaties in force and inevitably destined to trigger a reaction from the Swiss counterpart.

The issue becomes particularly intricate when considering that frontier workers are already subject to a number of taxes and contributions in Switzerland, such as the rare disease tax (Römer, 2017) and the health tax (Bundesgesetz über die Krankenversicherung, 1996). The health tax, in particular, seems set to create a double standard for frontier workers compared to Swiss citizens, as they are not subject to the same rules and requirements.

To better understand the impact of the tax on health, it is useful to look at some concrete examples. For example, if a frontier worker earns €50,000 per year and pays a monthly contribution of €150, this means that they will pay a total of €1,800 per year just for the health tax. In addition, if you consider that frontier workers are already subject to a number of taxes and contributions in Switzerland, the tax on

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Key points

The Ticino State Councillor Christian Vitta had already voiced the hypothesis at the end of January. Now it has become a formal parliamentary proposal: a motion presented to the Grand Council of the Canton of Ticino by the group leaders of PLR, Centro, UDC and Lega dei Ticinesi – Alessandro Speziali, Fiorenzo Dadò, Alain Bühler and Daniele Piccaluga respectively – asks the cantonal government to act "immediately" to suspend, totally or partially, the reimbursement to Italy of the portion of the tax at source levied on border workers, invoking the violation of Article 9 of the bilateral tax agreement by Italy. The proposal is based on Article 9 of the bilateral tax agreement between Switzerland and Italy, signed in 2019, which provides for mutual exemption from source taxes for persons resident in one of the two countries who carry out work in the other. However, the authors of the motion argue that Italy has not complied with this clause, by applying a health tax to Ticino border workers. According to them, the health tax was also applied to border workers who have already paid source tax in Switzerland, in violation of the bilateral agreement. "Switzerland was the first to respect the agreement and not to apply the health tax to border workers," says Alessandro Speziali, PLR group leader at the Grand Council of the Canton of Ticino. "Italy, on the other hand, has not complied with its commitments and has applied the The motion was also supported by some political representatives of the Citizenship Party (PC), who stressed the importance of guaranteeing citizenship and respecting the commitments made with the Italian government. The decision of the Ticino government to act "immediately" to suspend, totally or partially, the reimbursement to Italy of the portion of the tax at source levied on border workers was also supported by some political representatives of the Freedom Party (PL), who stressed the importance of guaranteeing freedom and tax justice and of respecting the commitments made with the Italian government. The motion was also supported by some political representatives of the Party of Christian Democracy (PDC), who stressed the importance of guaranteeing social justice and respecting the commitments made with the Italian government. The decision of the Ticino government to act "immediately" to suspend, totally or partially, the reimbursement to Italy of the portion of the source tax collected on border workers was also supported by some political representatives of the Party of the Revolutionary Left (psr), who stressed the importance of guaranteeing social justice and respecting the commitments made with the Italian government. The motion was also supported by some political representatives of the Freedom Party (PL), who stressed the importance of