he Cadillac tax was apt to be politically unpopular. It was particularly apt to be unpopular with politically active groups, such as unions. It therefore seemed somewhat unlikely to us that the Cadillac tax would ever be actually allowed to take effect. Don’t be alarmist, we were told; the administration knows that all the parts of this law hang together. It will not start disassembling the complicated structure it spent so much time and political capital putting together.
And to be sure, the administration has not capitulated in the face of considerable political pressure. Well, it has not capitulated much. The White House did agree to push the implementation date back to 2020 from 2018. That ObamaCare’s principle architects want to be safely away from 1600 Pennsylvania Avenue before the Cadillac tax is implemented gives you a pretty good idea of how politically viable it is.
President Barack Obama will propose reducing the bite of the unpopular “Cadillac tax” on high-cost health insurance plans in the budget he releases next week, in a bid to preserve a key element of the Affordable Care Act.
Jason Furman, the White House Council of Economic Advisers chairman, wrote in the New England Journal of Medicine that the president’s plan would reflect regional differences in the cost of health care, reducing the tax’s bite where care is particularly expensive.
“This policy prevents the tax from creating unintended burdens for firms located in areas where health care is particularly expensive, while ensuring that the policy remains targeted at overly generous plans over the long term,” Furman wrote in the Journal article.
There is little congressional appetite to revisit ObamaCare’s Cadillac tax in an election year, but that’s not stopping the coalition opposing it from campaigning about it.
Fight the 40, the coalition that includes unions and Fortune 500 companies as members, is still pushing for a full repeal of the 40 percent excise tax on employer-sponsored health benefits above a certain threshold. The tax was originally scheduled to go into effect in 2018 but was pushed back two more years in December.
“We will continue our work to highlight how the tax creates age, gender, and geographic disparities and how it impacts vulnerable demographics,” the group said in a memo shared first with Morning Consult.
This is the second year that the Affordable Care Act and taxes will collide, and two changes this year could make the cumbersome tax filing process a bit more complicated.
Janna Herron of The Fiscal Times fills you in on what you should know this time around—the forms, the penalties, and the deadlines.
Last week’s seven-candidate debate hosted by the Fox Business Network once again found much to discuss in terms of national security issues, immigration law enforcement, even a little economic policy, and, of course, the latest round of character attacks and counter-attacks. Still missing in action: at least the first subcutaneous probe of where the respective candidates stand on health policy issues.
Based on recent performance, it’s questionable whether health policy has attracted sufficient interest among the media and Republican primary voters to command more than a few seconds on the debate stage. But it’s not for lack of potential lines of inquiry.
Here are some questions to the candidates from Tom Miller of the American Enterprise Institute that still await new rounds of oversimplified, evasive, or (one might hope) thoughtful answers.
The decision states face of whether to expand Medicaid to non-disabled, working-age, childless adults—the Affordable Care Act primary expansion population—involves tradeoffs. These tradeoffs include higher taxes, reduced spending on items like education, transportation, or infrastructure, or reduced spending on other Medicaid populations such as the disabled, children, or the elderly. The ACA funding formula allows states to pass a much greater share of the costs of covering non-disabled childless adults to federal taxpayers, but the tradeoffs still exist.
On Sunday, January 17—hours before the Democratic presidential debate on NBC—Vermont Senator Bernie Sanders released details of his proposal to replace the entire U.S. health care system with a universal, government-run, single-payer one. In Sanders’ eight-page campaign white paper, entitled “Medicare for All,” the self-described “democratic socialist” outlines his plan’s core principles.
Warren Gunnels, Sanders’ policy director, retained Gerald Friedman, an economist at the University of Massachusetts at Amherst, to come up with a fiscal score of the Sanders plan. Friedman estimates that the plan would require $13.8 trillion in new government spending in the decade spanning 2017 through 2016. Avik Roy of the Manhattan Institute outlines why that estimate is far too low.
About 1.4 million households that got financial help for health insurance under President Barack Obama’s law failed to properly account for it on their tax returns last year, putting their subsidies at risk if they want to keep coverage. The preliminary figures were released by the IRS late Friday afternoon, a time when the government often reports unfavorable developments.
The Department of Health & Human Services’ Office of the Inspector General found that the Centers for Medicare & Medicaid Services (CMS):
• Did not have an effective process in place to ensure that advance premium tax credit (APTC) payments were made only for enrollees who had paid their monthly premiums; instead, CMS relied on each qualified health plan (QHP) issuer to verify that enrollees paid their monthly premiums and to attest that APTC payment information that the issuer reported on its template was accurate; and
• Had sole responsibility for ensuring that APTC payments were made only for confirmed enrollees and did not share these data for enrollees with the IRS when making payments.
The OIG determined that CMS’s processes limited its ability to ensure that APTC payments made to QHP issuers were only for enrollees who had made their premium payments.
According to the Department of Health and Human Services, half the uninsured who are eligible for subsidized coverage through the exchanges have refused to purchase it. As a result, those remaining in the insurance pool have tended to be sicker and older — and they’ve used more health services than insurers expected.
How much more? According to the consulting firm McKinsey & Co., insurers collectively swallowed $2.5 billion in unexpected medical expenses from exchange enrollees in 2014.