As a Republican-controlled Congress struggles to make good on its promise to repeal the Affordable Care Act, House Speaker Paul Ryan is quietly pushing a revolutionary change in the way that health care works in the United States.

At the present time, employers who provide health-care benefits to employees get a tax break; workers, on the other hand, don't pay taxes on the benefits they receive. Ryan and his allies want to limit these tax breaks on the grounds that they encourage companies and their employees to spend more on health care than is necessary.

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