Maybe not everybody but a lot of us, form the same report:
[quote/ The Kaiser Family Foundation, in a recent report, found that nearly 25 percent of employers would be subject to the tax when it starts in 2018. After that, Kaiser said, 30 percent of employers are projected to pay the tax by 2023, and 42 percent of employers by 2028. /quote]
There is pressure on the administration from unions not to implement the Cadillac tax because it would affect so many union health plans.
Note that a new study shows another type of increasing upward cost pressure that is independent of the ACA:
http://www.bmj.com/content/351/bmj.h5516-0
http://www.medpagetoday.com/PracticeManagement/Medicolegal/54498
Basically, physicians who prescribe higher cost treatments tend to get fewer malpractice lawsuits.
They may have had better patient outcomes, something the study did not address. Or the patients thought that their physician was doing everything she could to diagnose or treat them and therefore they were satisfied and did not sue.
I feel much better about our increase since reading this thread. We are in NC and my family of 3 (2 adults, one child) will see our monthly premium go from $490 to $570, we have a large deductible - $10K I think. We are grandfathered into our old plan so do not have most of the ACA protections.
We have had this plan since 2009 and the insurance company has never had to pay anything but I do understand we are one accident/illness away from them spending much more than our premiums. We take no prescription meds and seldom see the doctor. Since we pay, we look for the best price on any necessary tests and have saved thousands by doing so.
Luckily our out-of-pockets have averaged around $1000 per year.
A $10,200 individual plan for an older person doesn’t really sound like a lush plan, especially as health care plan costs increase. Labeling theses plans as “Cadillac Plans” implies that they are unnecessary, expensive luxuries, therefore the government is entitled to tax such friviolities.
Many union employees are angry, because they have sacrificed pay and benefits to negotiate for good health care plans. Some of the Union leadership strongly supported getting Obamacare passed, to the detriment of their membership, who now feel betrayed.
@doschicos The ACA disappearing would be a disaster for me. Several of my children and I would be uninsurable or our pre-existing conditions would be excluded. I can’t speak for anyone else but that’s my own situation. If the ACA disappeared, I would have to travel overseas for some of my healthcare but would be breaking the law when I return with cheaper medications.
^^^ This right here should have been addressed before passing this half a**ed law. I live in NJ where it was against state law to deny coverage for pre-existing conditions . I personally hope this gets repealed and replaced with something that everyone can benefit from without exorbitant costs to small business owners or individuals who can’t pay tooth and nail for basic coverage.
I would love to have the option of having medical insurance for castrophes only with a smaller premium. One size does not fit all.
There is not a penalty for having better insurance. The Cadillac tax is a penalty on employers, not on individuals who buy lavish insurance. Individuals who buy their own insurance are never subject to the Cadillac tax. Why does this make sense? Because that luxury health plan is a tax-deductible business expense for the employer.
In other words, employers are incentivized to give out expensive health plans because they don’t bear the entire cost. Suppose, instead, that the employer just gave the cost of the insurance premium to each employee, as additional salary. Then the employee could use that money to buy insurance-- but it would be taxed first, so they wouldn’t get a plan that was as good.
Some people say that employer-sponsored health insurance shouldn’t be tax deductible at all (for the employer). But the Cadillac tax makes it tax deductible only up to a certain level.
The $10,200 number is the average premium for all employees, not just older employees. If a company pays an average of more than $10,200 per employee, the premium over the threshold is taxed. And, again, the Cadillac tax does not apply to individuals buying private insurance, only to employers providing insurance to employees.
The trouble with that, Tatin, is that it takes healthy people out of the risk pool.
Even for those who are chronically ill, if they weren’t paying premiums and deductibles but paying out of pocket for their routine or inexpensive care, it would likely save money. Administrative costs for both the insurance companies and the providers would be lessened also. One wonders how much the paperwork, etc costs when millions of people use medical insurance for a doctor visit that costs$100. I don’t use my homeowners insurance when a window breaks, but for our system, why should anyone use insurance for a prescription that costs $20.
You don’t have to,us your insurance if you are willing to pay the retail cost of any drug.
For me, given that I am fortunate to have some assets, insurance is just that - an insurance policy. One serious illness or accident, requiring hospitalization and surgery, could wipe out a fair amount of assets.
To me, the problem with the old system AND the new ACA system is neither really addresses the issues of equal access to healthcare as a right, although ACA is an improvement in many ways. To me, especially in a country like ours which many people like to deem “the best country in the world”, healthcare should be a basic need that is met for ALL citizens, rich and poor, healthy and not so healthy. To me, access to healthcare should be viewed the same as a basic education which is provided to all children in our country until 12th grade. We don’t expect employers to be in charge of our kids’ education and to determine the quality of that education. It’s not like if mom or dad works for a Fortune 500 company their children get a better education than the kids of the mom and dad working for a small business or the children of the guy who lost his job. We don’t expect families of kids with special or remedial needs to pay more for their public education than we do for the brighter kid who picks up concepts quickly and requires less of the teachers time. We know it does cost more to educate some kids than others but we see that as providing a basic need. Why should healthcare be any different? Why should healthcare still come predominantly through an employer based model? It’s archaic and inefficient.
It is only that way because of historical accident*, and now many people are afraid of any kind of change (including the possibility of shopping for their own medical insurance and otherwise taking a more active role in managing their own medical care on an individual basis), so that (for political reasons) ACA did not break this connection (indeed, some of the ACA rules tied it tighter).
*During WW2 wage controls, employers could boost benefits instead to attract employees. More recently, employer-based medical insurance was “necessary” for large percentages of people who have pre-existing conditions that made them individually uninsurable, and even those who could get individual insurance preferred not to see the actual cost of such.
Well i do know from the gyn/ob at least where we live many birth control pills require preauth this year and it was the final icing on the cake whereby she retired early this year. She said the costs of all the preauths and regulatory stuff didnt make it worthwhile anymore. I have heard this from multiple doctors.
“There is not a penalty for having better insurance. The Cadillac tax is a penalty on employers, not on individuals who buy lavish insurance. Individuals who buy their own insurance are never subject to the Cadillac tax. Why does this make sense? Because that luxury health plan is a tax-deductible business expense for the employer.”
If the actual issue was the tax write off, the logical thing to do would be to disallow the tax deduction at that point, not levy a massive and disproportionately large tax on it.
It is more logical that this was intended to discourage employers from offering health insurance, to push more people into Obamacare.
Tatin, it may not be the case for the people on this forum, but let’s please remember that there are millions of Americans for whom a $100 medical bill is out of the question.
Her beef is with the insurers, as I’m sure she very well knows. There is nothing in ACA which forces insurance companies to require pre-authorization for birth control. They decide to do that all by themselves. And in fact, many insurance companies don’t do it. So you can’t blame ACA for that.
Cms derermines the guidelines for plans of care for medicare and medicaid. The obama care providers ie insurance companies are required by law to follow cms guidelines. The increased claims preauthorization diligence is driven from cms guidelines. Hence why more drugs are requiring preauthorizations. The state insurance commissioners can add drugs that require additional scrutiny so it can vary from state to state. However if a drug is on federal list in all 50 states preauthorizations are required by obama plans on the exchanges. Cms guidelines have increased their scrutiny to help manage the costs of obama plans, medicare and medicaid. Currently insurers competing in the individual market on the exchanges are losing money.
And yes the birth control pill that is prescribed under the state formularies list requires preauthorization. Hence if you have medicare, medicaid or an obama plan it is required to have preauthorization and with private insurance or group its up to the insurer. So yes the aca has in fact affected preauthorizations. And i looked up the acne medicine and ditto for that. So the meds that have been prescribed for years that i have gotten now require preauthorizations looking up state formulary list. Please keep in mind i didnt say every birth control pll or acne medicine but the ones we are prescribed yes they require authorization by state rules.
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However if a drug is on federal list in all 50 states preauthorizations are required by obama plans on the exchanges.
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My daughter has an “Obama plan” – or more accurately, private ACA-compliant insurance purchased on the exchange – and she did not have to get pre-authorized for her birth control. The fact that you have to get pre-authorized does not mean that everyone everywhere has to get pre-authorized.