Most discussions about insurance costs center around premium increases, or (less often) deductibles. Less often do we here them discussed together. Yet, the combination is a critical factor in determining how illnesses affect the financial well-being of families.

An insured family has to pay its premium regardless of whether or not any claims are made. In addition, a family has to meet its annual deductible before receiving any benefits for treatment of illnesses or injuries. That means a family has to pay the total of the premium plus the deductible before any benefits are payable.

On Wednesday, Kentucky Governor Matt Bevin announced that he was planning to keep ObamaCare’s Medicaid expansion, but would seek federal waivers to “transform” the program. But Bevin’s plan is already hitting an a snag: he wants to use a Section 1332 waiver to “transform Medicaid.” The snag: Section 1332 doesn’t provide any authority for Medicaid reform.

Even with federal government subsidies under the Affordable Care Act, a typical American buying coverage on public exchanges spends about one in 10 dollars they earn “on insurance premiums and out-of-pocket costs,”according to a new analysis.

Research from the Urban Institute shows typical single enrollees with incomes between $23,540 and $58,850 spend 10% of their incomes on premiums and out-of-pocket costs and the percentage rises if the enrollee has more medical needs.

On December 14, former Secretary of the Department of Health and Human Services Kathleen Sebelius made news by calling the decisions of Kansas and Missouri to turn down the Medicaid expansion contained in the Affordable Care Act “morally repugnant and economically stupid.”

Heated political rhetoric does not alter the fact that a state’s decision to expand Medicaid involves complicated tradeoffs.

The Cadillac tax contained in the Affordable Care Act represented an attempt to remedy a major problem with health care and tax policy – the exclusion of the cost of employer-sponsored insurance from both income and payroll taxes. Regardless of political leanings, economists generally agree that the exclusion causes employers to offer overly expansive insurance. This depresses wages and increases overall health care spending. Moreover, the exclusion provides a disproportionate benefit to the wealthy.

It goes without saying that delaying a scheduled tax increase is a tax cut. According to the Joint Committee on Taxation, a two year delay of the Cadillac tax combined with deductibility will save taxpayers $20 billion over the next decade. Conservatives are for tax relief.

Conservatives are for repealing ObamaCare, in whole or in part. The Cadillac Plan excise tax is a part of how ObamaCare’s latticework of subsidies and regulations is supported. Delaying on the road to repealing parts of the ObamaCare law is good public policy. Eventually, we want to repeal and replace all of ObamaCare.

Some of my colleagues are blasting the Republican leadership for delaying three of ObamaCare’s taxes as part of the $1.14 trillion end-of-the-year tax extender and spending package scheduled for a House vote on Friday.

The legislation provides a two-year delay in the “Cadillac” tax on high-cost health insurance policies that labor unions were pleading to repeal; a two-year delay in the medical device tax that is drying up research budgets in this critical industry; and a one-year delay in the Health Insurance Tax (HIT).

There has been some interesting coverage lately about Florida Sen. Marco Rubio’s successful effort to ensure that taxpayers were not on the hook for excess losses incurred by insurers participating in Obamacare’s exchanges. Today, however, two Associated Press reporters alleged that this victory against the law was one that Rubio “didn’t deliver.” But the facts show that Rubio is right, and the AP is wrong.

According to the Organization for Economic Cooperation and Development (OECD), the United States spends $8,713 per person on health care — more than double the OECD average.  But under ObamaCare, that high level of spending isn’t buying the best care. The law’s numerous regulations and intrusions have simply inflated the nation’s healthcare tab — without actually improving the quality of care available to patients. The US has long spent more than other nations on care. ObamaCare has just accelerated that trend, despite the law’s goal of reducing health spending. Last year, health expenditures jumped 5.3%, up from an average of 3.9% over the previous six years, according to data from the Centers for Medicare and Medicaid Services.

The two-year “Cadillac tax” delay under consideration by Congress is the worst kind of special-interest legislation. It will enrich labor unions and big business at the expense of taxpayers. ObamaCare’s Cadillac tax is a clunky but constructive first step in reforming the employer tax exclusion. It has problems—its structure as an excise tax is punitive, and it contains carveouts for favored Democratic constituencies—but the basic idea of equalizing the tax treatment of employer- and individually-purchased health insurance is a good one.