In Switzerland’s already tense relationship with Italy because of Crans-Montana, the Meloni government’s health tax for cross-border commuters is becoming a political issue.
March 1, 2026, 10:31 p.mMarch 1, 2026, 10:42 p.m
Gerhard Lob / ch media
The fire disaster in Crans-Montana, which claimed 41 lives on New Year’s Eve, including six Italians, and 115 people, most of them seriously injured, is putting a great strain on Italy’s relationship with Switzerland. But this is not the only point of friction between the two neighboring countries. The health tax for cross-border commuters decided by Italian Prime Minister Giorgia Meloni in December 2023 is currently causing red heads. Although this tax has not yet been levied, it has just been renewed in Italy’s budget law.
Italy’s Prime Minister Giorgia Meloni wants to slow the exodus of health workers to Ticino.Image: keystone
While initially only the Italian unions described the health tax as illegal and a violation of the bilateral cross-border commuter agreement, at least in Ticino all center-right parties are now convinced of this interpretation. In a new motion, the FDP, SVP, Center and Lega are calling for the refund of withholding taxes from cross-border commuters to Italy to be blocked in the spirit of a retaliation.
Up to six percent of income
The Ticino finance director Christian Vitta (FDP) had previously suggested in an interview with the “Corriere del Ticino” that the reimbursement be reduced by the amount that should be deducted from cross-border commuters through the health tax on their Swiss income in Italy. The resistance is justified by a clause in the cross-border commuter agreement, according to which Italians are only liable to pay taxes in Switzerland.
This formula applies to all cross-border commuters who received their work permit before July 17, 2023. Anyone who started working in Switzerland later is subject to the new tax agreement. Part of the salary is taxed in Italy at the local rates.
The health care tax should amount to three to six percent of income. The Italian government wants to use the proceeds to increase wages for nurses and doctors on the Italian side and to make working conditions there more attractive. Hospitals and retirement homes in the border belt with Switzerland suffer from the fact that the majority of skilled workers work in Ticino, where wages are significantly higher.
The federal government does not want to allow the conflict to escalate
The implementation of “Tassa sanitaria” is the responsibility of the regions. Piedmont, as a border region with Ticino and Valais, has already declared that it will not levy this tax. Lombardy, on the other hand, does not want to do without it. However, she still lacks data on the income of cross-border commuters. Representatives of Lombardy have reacted coldly to threats from Ticino to freeze or reduce the repayment of withholding taxes.
Italian border communities are also concerned. It’s a lot of money: more than 100 million francs are reimbursed to the Italian communities every year from Ticino. Almost 80,000 cross-border commuters work in Ticino, the majority from Lombardy, especially the Como-Varese area.
The State Secretariat for International Financial Affairs has stated several times recently that it has not been legally proven whether the planned health care tax can be interpreted as a tax and thus actually violates the old cross-border commuter agreement. However, it is clear that withholding taxes at source represents a clear violation of this agreement. The impression is that Bern is not interested in escalating another source of conflict with Italy with the health tax.
Trade association president warns of consequences
The number of cross-border commuters in Ticino has recently fallen from 80,000 to around 78,000. This is probably related to the new tax agreement, which has reduced the attractiveness of working in Switzerland. Employers in Ticino, especially the industry association, are watching the situation with concern. Because the search for skilled workers is becoming increasingly difficult.
The health care levy, if it is actually levied, could further exacerbate the tense situation on the labor market. As early as 2024, the Ticino Center Council of States Fabio Regazzi, President of the Swiss Trade Association, stated in an interpellation: “The application of this fee, which is similar to a tax, could harm Swiss companies near the border, which are already having difficulties finding qualified workers.”