Under the Affordable Care Act (ACA), in 2018, an excise tax on high-value employer provided health plans, the so-called “Cadillac tax,” takes effect. Even before 2018, though, the excise tax is already driving many employers to fundamentally reassess their health care plans. While the tax was intended to reduce health care spending, its impact in the real world is being felt by workers who are seeing the value of their health care plans reduced.