The White House has proposed an additional $59 billion in changes to the tax code that would help pay for the cost of efforts to cover the more than 40 million Americans without health insurance, including a substantial tightening of estate and gift tax rules. Budget documents reiterate President Barack Obama's plans to create a $630 billion "health reform reserve fund" to help pay for the healthcare efforts, which are expected to cost at least $1.2 trillion over 10 years.