As policymakers debate repealing and replacing the ACA, they grapple with how to address the ACA’s “Cadillac Tax.” Rather than repealing the 40% tax on high-cost insurance plans outright, many advocates of “repeal and replace” have proposed replacing it with a limit on the tax exclusion for employer-sponsored health insurance. Doing so would be a wise choice, and limiting the ESI exclusion would both generate significant revenue to pay for an ACA replacement and help to limit the overall growth of health care spending. Other options include capping the income tax exclusion, capping the payroll tax exclusion, and replacing the income tax exclusion with a fixed-dollar credit/deduction.
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Following an Obama administration order, the IRS had been set to require taxpayers to indicate on line 61 on their form 1040s whether they had maintained health coverage in 2016 or paid the penalty. The IRS would have rejected returns if taxpayers failed to report their coverage status. But the IRS announced this week it would not reject returns that failed to check the appropriate ObamaCare boxes—an early indication of the administration’s efforts to provide relief from ACA mandates.
“This year, the IRS put in place system changes [initiated by the Obama administration] that would reject tax returns during processing in instances where the taxpayer didn’t provide…information [attesting that the taxpayer had health insurance].
“The recent executive order [issued on day one of the Trump administration] directed federal agencies to exercise authority and discretion available to them to reduce potential burden. Consistent with that, the IRS has decided to make changes that would continue to allow electronic and paper returns to be accepted for processing in instances where a taxpayer doesn’t indicate their coverage status.”
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Obamacare repeal and replace is going to turn into a huge tax cut. Those reading the tea leaves would do well to consult two sources as to how and why: the 2015 repeal bill, and the House GOP “Better Way” health care blueprint. Just as in the 2015 bill, which was vetoed by President Obama, Congress aims to repeal all of the 20 major new or higher taxes in Obamacare. It’s important that this repeal be effective at the beginning of 2017, both to get rid of negative Obamacare taxes as soon as possible and to lower the current law’s revenue baseline for tax reform.
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Congressional Republicans are facing their first big decision on taxes under President Trump: Which ones to scrap in the repeal of ObamaCare.
Republicans have in the past sought to erase most of the big tax hikes in the healthcare law, and the chairmen of the tax-writing committees have expressed support for eliminating the taxes in a repeal bill.
“After spending seven years talking about the harm being caused by these taxes, it’s difficult to switch gears now and decide that they’re fine so long as they’re being used to pay for our healthcare bill,” Sen. Orrin Hatch (R-Utah), the chairman of the Senate Finance Committee, said Wednesday.
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This week, the U.S. Senate and then the U.S. House of Representatives will consider a budget resolution for FY 2017. It has no purpose whatsoever except to create a vehicle for the repeal of Obamacare.
Congress should pass this budget resolution. It doesn’t commit anyone to any policy choices at this point. All it does is create reconciliation instructions for the chambers to pass Obamacare repeal shortly after President Trump is inaugurated.
This budget resolution has nothing to do with the actual budget, unlike any budget resolution in memory. All it does is create reconciliation instructions for the chambers to pass Obamacare repeal shortly after President Trump is inaugurated.
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Republicans have said they want to move quickly to craft a replacement plan after successfully repealing Obamacare. But it is not clear how they will pay for a key part of that replacement, tax credits to pay down health insurance.
Republicans have not released a replacement plan for repealing Obamacare. However, some Republicans have introduced legislative text that give a sense of the direction the GOP wants to go.
For instance, Rep. Tom Price, the Georgia Republican who President-elect Trump nominated to be secretary of the Department of Health and Human Services, has a plan. Price’s Empowering Patients First Act includes tax credits that are pegged by age instead of income so a person who is younger would get a smaller tax credit than someone older who presumably has higher healthcare costs.
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Donald Trump’s White House and congressional GOP leaders are coalescing around an agenda focused on slashing taxes and repealing Obamacare early next year, a blueprint that could potentially avoid an intraparty clash over infrastructure investment early in Trump’s presidency.
On Wednesday morning, incoming White House Chief of Staff Reince Priebus said that the GOP will concentrate on budgetary issues and health care reform in the first nine months of the year. That largely overlaps with House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell’s focus on tax reform and Obamacare repeal and suggests the party will spend much of its energy and momentum on those two issues.
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Next year, taxpayers will fork over nearly $10 billion more to cover double-digit premium hikes for subsidized health insurance under the ACA, according to a study from the Center for Health and Economy. The study estimates that the cost of premium subsidies under the ACA will rise from $32.8 billion currently to $42.6 billion. Under current law, “you get a premium increase, you pour more money in,” said economist Douglas Holtz-Eakin, founder of the Center for Health and Economy. “The concern is that will feed more premium increases.” If the health care law is repealed next year, it is still yet to be seen what the remaining carriers participating in the ACA exchanges will do in 2018. It is also unclear how supportive Congress will be for subsidies going into a system slated to disappear.
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If Donald Trump and the Republican Congress have a mandate to do anything, it is to repeal Obamacare. The law is already cratering. Sick enrollees, former president Bill Clinton laments, are seeing “their premiums doubled and their coverage cut in half.” Even supportive economists admit the program is in a death spiral.
Repeal won’t be easy. But if Trump sets for Congress the same agenda he laid out during the campaign, he could become America’s greatest health-care reformer, all while cutting taxes more than Ronald Reagan and George W. Bush combined.
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The health care crowd in the Beltway is abuzz this morning with press reports that president-elect Donald Trump has named Georgia Congressman Tom Price, M.D. as Secretary of the Department of Health and Human Services. In a related move, he will name longtime Mike Pence aide Seema Verma to the critical role of administrator of the Center for Medicare and Medicaid services. As a result, there’s a raft of interest in how Obamacare “repeal and replace” will now proceed.
It’s important to not get ahead of ourselves here and reflect on what a huge pro-taxpayer accomplishment Obamacare repeal will be. By all accounts, Obamacare will be off the books early in 2017, perhaps before the Patriots win their fifth Super Bowl in NRG Stadium in Houston on the first Sunday in February. Understandably, most of the attention has been focused on the health care aspects of this. But this action will be an enormous tax cut for the American people, with implications for tax reform later in the year.
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