Labor Unions' Latest Problem: Obamacare's 'Cadillac Tax' Harms Their Gold-Plated Health Insurance Plans
As health coverage expands to tens of millions of Americans--through Medicaid expansion in states and the new state health insurance exchanges that will soon begin selling individual health coverage--some Americans with employer-sponsored health coverage are seeing their benefits decrease.
One of the most significant, and controversial, provisions of the Affordable Care Act is the new excise tax on high-cost health plans proposed to both slow the rate of growth of health costs and finance the expansion of health coverage. The provision is often called the "Cadillac" tax because it targets so-called Cadillac health plans that provide workers the most generous level of health benefits. These high-end health plans' premiums are paid for mostly by employers. They also have low, if any, deductibles and little cost sharing for employees.
Proponents of the new excise tax argue that these benefit-rich plans insulate workers from the high cost of care and encourage the overuse of care--such as unnecessary tests and hospital visits--that raise US health costs overall. However, the plans may be more costly and therefore subject to the new excise tax for reasons other than their generous benefits, including plan participants' health status or advanced age.
A 40 percent excise tax will be assessed, beginning in 2018, on the cost of coverage for health plans that exceed a certain annual limit ($10,200 for individual coverage and $27,500 for self and spouse or family coverage). Health insurance issuers and sponsors of self-funded group health plans must pay the tax of 40 percent of any dollar amount beyond the caps that is considered "excess" health spending.
Although the excise tax does not take effect for another four years, many employers are already scaling back their health benefit offerings or increasing workers' deductibles and copays to avoid paying the tax. Proponents argue that employers need a renewed focus on cost control, and that when consumers must pay a share of the costs, they will be less likely to overuse care.
For consumers, especially those in poor health or with chronic illnesses who rely on Cadillac plans to cover high annual medical expenses, the tax means that they'll have to pay much more for their health care. Critics of the tax say it unfairly "hollows out" and "slashes" health benefits.
It's not yet clear how widely the excise tax will be felt by both employers and consumers. This brief explains the tax, its current and projected effects, and what's next in the debate as the tax moves toward full implementation in 2018.
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