The so called “Cadillac” tax is, in reality, a teacher tax. It taxes plans based on their cost, but not their generosity. As anyone who has bought health insurance will tell you, the biggest factor in determining the cost of insurance is not how generous the coverage is, but the sex, age, and health status of the buyer. As a result professions that tend to employer older, less healthy females–like teaching–will bare the brunt of this excise tax, regardless of how generous or bare bones the policies.
There are plenty of ways to redesign the teacher tax to make it an actual “Cadillac” tax. It would need to be indexed to some form of medical inflation to prevent it from hitting “Chevy” plans as time moves forward. You can force all insurers to use true community rating–charge everyone one price regardless of age or health status. It can, instead, base the tax on actuarial value, benefits covered, and/or co-pay design. You can calculate how much a policy would cost if bought by a group with average age and health status, and base the tax on that value.
A big problem is that the tax does none of these things. It is based on just a price tag not generosity of the benefits. As a result, it is not a tax on gold-plated insurance policies, but a tax mainly on older Americans, women, people with health problems, and those who work with them.
If I had a snowboard shop in Utah that employed only young, healthy people under thirty, I could probably buy the most over-the-top platinum insurance policy–one that covers dental, vision, plastic surgery, and botox with no out of pocket costs–and it would still be below the excise tax limit. On the other hand, if I ran a private school in Maine–one with most of the teachers being woman over 50 with health problems–I would probably find it impossible to find anything but very-low-quality, junk insurance that did not get hit by the excise tax.
Even if you support taxing “overly generous” health insurance, you should not support this particular excise tax in the Senate bill. It will not tax generous policies, just expensive policies. Until we force insures to charge everyone the same price regardless of age, the tax will disproportionately hit older, sicker Americans, and not exclusively those with extremely comprehensive insurance. If you want a “Cadillac” tax, at least of the decency to design a tax that just hits plans with generous benefit packages. Don’t give us a poorly designed and discriminatory teacher tax Edsel, and then try to spin it into an Escalade.



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a prime example of this–based on price not coverage–is what is happening to people on COBRA.
The exact same Kaiser plan is $350 on COBRA but goes up to $750 when COBRA expires.
The same coverage is now a Cadillac plan because it is individually rated by age and condition.
Excellent points.
This excise tax is just another instance of the general problem with any approach to healthcare reform that relies on the for-profit insurance model rather than adopting single-payer or public-utility model. Insurance is only profitable when you sell coverage to those that don’t need it and deny it to those that do. You profit by collecting premiums and keeping them, not by paying them out for medical problems. So any system that has the old and sick paying into a different risk pool from the young and healthy will result in rich insurance companies and expensive healthcare.
In this instance, any excise tax that discriminates based on cost must necessarilly tax the use of healthcare while exempting the profits derived from health insurance.
The tax will hit a group that probably votes 95% Democrat and let the fatcats skate. This bill should henceforth be known as The Democratic Self-Destruction Act.
http://www.myfederalretirement.com/public/576.cfm
I repeat: debating the terms and conditions of an utter disaster is a fool’s errand. The particulars of the collapse of the progressive movement’s health care reform agenda, triggered by a bunch of bomb-throwing politicians in the Democratic Party owned and operated by the health insurance and pharmaceutical cartels, are in some very deep way irrelevant.
We, the members of the broad working public, the people in the country who AREN’T rich, are being attacked, by those who ARE rich. The weapons being used against us are the mechanisms of legislations and the people pulling the trigger to fire at us are the very politicians we elected a little over a year ago as they claimed they would represent us and pursue our reform agenda.
Blame lobbyists? NO! Blame the lobbied! Every single son of a bitch sitting in an office in DC who took the donations and payoffs and rewards and quid-pro-quos had a choice in the matter and most of them never batted an eye to be sure.
This is class war. We are taking fire. The only question is what weapons to use back, and how to aim them and fire them. This is the only context in which debate of the excise tax versus yet another “funding mechanism” for what is overall an attempted rape of the American middle class can be debated. Disasters have no merits to opine upon. There is a time for a debate and a time to fight back. Look at what is upon us. It’s obvious what time it is.
Let’s all each and every one of us focus our civic lives, in the time we have for such things, on producing electoral annihilation for the Democratic Party in 2010. And in the meantime, let your voice be heard: kill the god damned bill already! It’s a travesty and the legion of nefarious figures who have created it have no shame.
If I recall from earlier today, the cadillac tax will not be imposed upon employees with benefits through collective bargaining per the Whitehouse talks with Labor. If that is the case, my fear is that the general public will hold Labor responsible for saddling “Them” with the burden of the individual mandate for high cost, crappy coverage. If so, goodbye EFCA.
On the other hand, California Senator Mark Leno will be introducing SB 810 which truly is comprehensive single payer for all californians. This is the model. It has NO role for the insurance industry – which is why Der Gropenfueher votoed it twice when it was known as SB 840.
Given a choice between the crappy sausage of corporate welfare – be it the House or the Senate version – I’ll take universal, comprehensive, single-payer any day. Once this bill is law, it will be a pleasure to go to the bargaining table and negotiate wage increases instead of the Sophie’s Choice of wages OR benefits, with no winners and plenty of losers on both sides of the table. At the current rate of premium increases (and unsupportable profits at the cost of needless suffering) neither employer or employee can continue to shoulder the ever-increasing burden of health insurance.
Sounds like the union bosses are going to go along with the plan as long as they are exempted and EFCA comes up for a vote. EFCA??? Forgetabout!!! If Harry Bridges were alive today he’d kick the shit out of all the limp dicked labor “leaders,” no ideology and even less fight. Next time anyone interviews Trumka I hope they ask him if the suit he’s wearing is an Armani. You can bet it’s not off the rack from Sears.
What happened to the pix of the rusty Edsel? I hope that the so-called “Cadillac” tax suffers the fate of the Edsel. It deserves a place in a junk yard.
Thanks for this analysis!
Bob in AZ
The best hope we have, and its a slim but not unacheivable hope, is to kill this montstrosity. The Only two things that obama cares about are getting his relection campaign fully financed, and saying he got something big and historic passsed. (oh it should be historic allright) So we keep up the effeorts in the house to kill it. But if the worst hoppanes and it passes, the worst isnt over its just beggining. This is allready one of the most unpopular pieces of
shitlegislationshit ever considered by congress, and most people dont even know how staggeringly bad it is yet. if it passes, there are going to be unemployed democratic and republican politicians as a result. we have to make sure that number is as large as possible and continue to work on getting it overturned and on possible court challenges to the most odious parts of it.Irony
Spending the better part of a year working towards healthcare reform only to end up opposed to the bill in the end
Where did you get specifically older women, instead of just older employees? Are women less healthy than men? How do they manage to live longer?
Obama loses politically, shattering his coalition, whether this bill passes or fails, and he has nobody to blame but himself for making choices which have put him in this position.
Hiya firepups!
No but the tend to have higher health care cost.
I believe that working towards the passage of SB 840 in CA will eventually lead to universal coverage nationwide.
SnarkWoman! How are you? Heard about Mother Jones the other night.
Yes! As goes CA, so goes the nation. For good, or for bad.
If you want the details on this well crafted plan, that even the Lewin Group determined would save a HUGE amount of money, check out onecarenow.
We have already had to fight the politicians for the right to have the same price structure as men. Since we have fancier parts we tend to have more expensive procedures. Pap smears, mammograms, bone density studies, menopause issues, period issues, pregnancy, etc. So, in situations like female dominated professions, we are more costly. And humans are more costly as they age.
I saw it the other day. And I have worked with SEIU and M.Moore on HCR.
I haven’t done anything lately but blog. I really need to get back into the action.
Didn’t you love all of the medical students showing up from around California?
The Dems in the House have to dig in and refuse to vote for the Senate benefit tax. Time to draw the line in the sand on this issue. Obama and Reid have to grow a pair and go reconciliation if they have to.
But do their health insurance plans actually cost more? My experience has been the opposite.
I don’t think we can say today that As California Goes, So goes America. They have had the Initiative and it’s effects a long time now and that has made all the difference.
I’m old. My health ins. makes me appear to be a ‘Cadillac’ — wait you yokels, with the ballooning costs, you will all soon be ‘Cadillacs.’ Sickening sellouts sold us down the river.
TAX and CAP the F…ing PROFIT of the F..ing health industry extortionists. Dump every politician so incredibly stupid as to think they can pass crap that victimizes old women who have a life they have given in public service.
Better yet- run all those old women for congress and senate. Unquestionably loyal, smart and dedicated and incredibly brave- they actually know a thing or two about making a better society.
Eject this pack of political thieves right out of their smug, self-aggrandizing seats.
Every contract that a educator has negotiated despite the whine of political operatives in order to take over the $500 B pot in education is just as sacred as any corporate contract written for the basest of market interests.
You are missing the objective. It’s not to provide health insurance or health care.
It is to bend the employers cost curve.
That’s it.
Ondelette
It is precisely because women live longer that insurance companies justify gender rating. They also justify it on the basis of our expensive baby makers. Women live longer than men but have more chronic conditions.
Premiums go up with age.
Jon mentioned teachers because they are precisely the sort of group who is villified for their benefits, for striking to ensure better working conditions, and who have undoubtedly sacrificed pay for their health benefits.
Just keep in mind that Congress’ Cadillac plans aren’t going to be hit.
Well lets bend their profit curve.
If we bend it far enough it might fit right…..
gross out wages, open up insurance across state, and maybe even country borders, let ocmpetition flourish,a nd let people get intot he risk pool that best suits them, be it their church, their neighbourhood, customers of costco….whatever….
getting insurance from your emplower is a bad premise….
and I am thinking a snowboard shop in Utah might have high premiums based on the number of broken bones your employers might get snowboarding;)