ObamaCare’s “Cadillac tax” has emerged as a sticking point in bipartisan negotiations over delaying certain health-care taxes before the end of the year.

Democrats are pushing to delay the “Cadillac tax” on high-cost health plans, which is despised by unions, but Republicans are pushing back and have resisted including the Cadillac tax in the package, sources say.

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As small business owners learn what their 2018 health insurance costs will be, some are considering providing different types of coverage for their employees.

Companies are receiving notices of premium and coverage changes for 2018. The changes vary, depending on factors including the state where a company is located, how many employees it has and how comprehensive its insurance is. But many owners are seeing rate increases of double-digit percentages, finding dramatically reduced coverage, or both. Health insurance consultants expect more owners to rethink their strategies beyond 2018 and choose alternatives like paying for claims themselves or adding health services that can lower costs.

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The House and Senate recently passed tax reform bills because they successfully made the case that reform is a “once-in-a-generation” opportunity that is long overdue. It’s a compelling argument. When the last tax reform bill passed in 1986 the Internet was in its infancy and cell phones were the size of a briefcase. The world has changed, the argument goes, but our tax code has not.

What’s curious, however, is that the largest deduction in the tax code – the exclusion from income tax of employer-sponsored insurance, which dates back to the 1940s – is untouched by the reform bills. This omission is an enormous missed opportunity for American consumers and both political parties.

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Anne Cornwell considered two drastic strategies in her quest to get affordable health insurance premiums last year for herself and her retired husband.

One was divorce. Another was taking a 30 percent pay cut. She chose the latter.

That maneuver slashed the premiums for the couple, who live in Chattanooga, Tenn., from exorbitant to economical. Instead of $2,100 a month — the amount she had been quoted for 2017 — their premiums are just $87 monthly, her lost income more than compensated for by qualifying for insurance subsides.

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As Republicans and the Trump administration continue trying to chip away at the Affordable Care Act, the Internal Revenue Service has begun, for the first time, to enforce one of the law’s most polarizing provisions: the employer mandate.

Thousands of businesses — many of them small or midsize — will soon receive a letter saying that they owe the government money because they failed to offer their workers qualifying health insurance. The first round of notices, which the I.R.S. began sending late last month, are being mailed to companies that have at least 100 full-time employees and ran afoul of the law in 2015, the year that the mandate took effect.

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The Trump administration is moving ahead with Obama-era requirements to post calorie counts in restaurants, supermarkets, convenience stores and pizza delivery chains nationwide next year.

Despite years of opposition by some food sellers, the Food and Drug Administration is offering only minor compromises to industry complaints about the difficulties of displaying calories at takeout chains, self-service buffets and other non-restaurant food locations.

The FDA posted a preliminary guidance online Tuesday to help businesses comply with the law.

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Dr. Ezekiel Emanuel, recently described in the Chicago Tribune as “a trusted ally of former President Barack Obama and chief architect of the Affordable Care Act” has proposed in this week’s Journal of the American Medical Association (JAMA) a new “Affordability Index” to measure trends in the affordability of employer-provided health coverage.  Tracking the affordability of employer-sponsored insurance (which I will shorthand as ESI) is certainly worthwhile and important given that over half of the nation’s population relies on such coverage.

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Anthem’s membership in the Affordable Care Act marketplaces will decline by 70% in 2018, executives told investors Wednesday on the insurer’s third-quarter earnings call. About 1.4 million people had ACA-compliant plans with Anthem as of Sept. 30, 900,000 of whom bought coverage on the exchanges.

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Although the GOP’s plan to repeal the Affordable Care Act industry taxes died with the party’s health care bill, it’s conventional wisdom that some of the taxes will still be delayed. But there’s no plan to do so yet.
Lobbying campaigns to repeal or delay the health insurance tax and the medical device tax are ramping up, yet there’s no clear vehicle for Congress to take action. Well-wired lobbyists and Hill aides say the appetite for doing anything major on health care isn’t really there.

“It is a have-to-get-done that’s really hard to get done,” said one lobbyist.

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Democrats loudly complain that people will lose health insurance if the Affordable Care Act is repealed. They never mention those who lose jobs because the ACA remains.

The ACA includes a penalty on employers that fail to provide “adequate” insurance for full-time workers. Thanks to the ACA, hiring the 50th full-time employee effectively costs another $70,000 a year on top of the normal salary and benefits.

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