Obama’s Cadillac Tax Crashes and Burns Killing Obamacare and Injuring MIT Professor Gruber — Rest In Peace — Obamacare Is Shovel Ready — Videos
The Pronk Pops Show Podcasts
Story 1: Obama’s Cadillac Tax Crashes and Burns Killing Obamacare and Injuring MIT Professor Gruber — Rest In Peace — Obamacare Is Shovel Ready — Videos
ObamaCare a Trojan Horse for Single-Payer
Obama lies about “cadillac” plan taxation
36 Times Obama Said You Could Keep Your Health Care Plan | SuperCuts #18
ACA Architect Confession: Created Lies For Obama
Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans
What is the “cadillac tax?”
Obamacare’s Cadillac Tax Pushing People To Plans With High Deductible- Union You Got What You Wanted
Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans
The Five: Large Employers Cite ObamaCare “Cadillac” Tax In Reducing Benefits
SMOKING GUN! Gruber Admits Obama Was in Room During Planning of Cadillac Lie
GRUBER: “Lack of transparency is a huge political advantage.”
GRUBER; Deceive Americans Critical to Pass Obamacare-Calls us ‘Stupid Americans’; Part 1 of 3
Gruber Remarks Puts Obama Administration on Scramble; Part 2 of 3
Jonathan Gruber: States Which Do Not Set Up an Exchange Do Not Get Tax Subsidies
BookTV: Jonathan Gruber, “Health Care Reform: What It Is, Why It’s Necessary, How It Works”
Jonathan Gruber admits Obamacare is inherently unaffordable
Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans
Krauthammer rips Jonathan Gruber: “We’re hearing the true voice of liberal arrogance”
Megyn Slams ObamaCare Architect Who Declined to Appear on ‘Kelly File’
Democrats Loved Jonathan Gruber Before They Forgot Who He Was
Sen. Harry Reid, 2009: Gruber Is One Of The ‘Most Respected Economists’ Out There
Sen. Harry Reid (D-NV) in a December 2009 floor speech on Capitol Hill lauded Jonathan Gruber as one of the most “respected economists in the world” as Reid cited facts defending the Senate’s Obamacare bill.
Nancy Pelosi In 2009: Americans Should Read Jonathan Gruber’s ObamaCare Analysis
Nancy Pelosi In 2009: Americans Should Read Jonathan Gruber’s ObamaCare Analysis (November 5, 2009)
AHEC 2013 Conference
As part of the 24th Annual Health Economics Conference hosted by PennLDI, Mark Pauly and Jonathan Gruber were featured in the Plenary Panel discussing the role of economics in shaping (and possibly reshaping) the ACA. See below for the conference agenda with links to working papers. See the full AHEC agenda: http://ldi.upenn.edu/ahec2013/agenda
Jonathan Gruber at Noblis – January 18, 2012
The Noblis Technology Tuesday speaker series covers a broad spectrum of political, technical and innovative ideas. Noblis is a nonprofit science, technology, and strategy organization that brings the best of scientific thought, management, and engineering expertise with a reputation for independence and objectivity. The opinions expressed in this video are those of the speaker and do not necessarily reflect the views or opinions of Noblis.
Jonathan Gruber spoke to a Noblis audience on January 18, 2012 Few experts know more about America’s dire need of health care reform than Gruber. And of that short list, he is the only one prepared to enter the pages of a comic book to make the case. To be clear: Gruber is not an expert; he is “the” expert. An award-winning MIT economist and the director of the Health Care Program at the National Bureau of Economic Research, he was a key architect of the ambitious health care reform effort in Massachusetts and is a member of the Health Connector Board now implementing it; in 2006 he was named by “Modern Healthcare” as the nineteenth most powerful person in health care in the United States. In 2008 he was a consultant to the Clinton, Edwards, and Obama presidential campaigns. The national legislation passed by Congress in 2009 derives directly from Gruber’s insights learned during the Massachusetts health care debate.
Honors Colloquium 2012 – Jonathan Gruber
Dr. Jonathan Gruber is a Professor of Economics at the Massachusetts Institute of Technology, where he has taught since 1992. He is also the Director of the Health Care Program at the National Bureau of Economic Research, where he is a Research Associate. He is an Associate Editor of both the Journal of Public Economics and the Journal of Health Economics. In 2009 he was elected to the Executive Committee of the American Economic Association. He is also a member of the Institute of Medicine, the American Academy of Arts and Sciences, and the National Academy of Social Insurance.
Dr. Gruber received his B.S. in Economics from MIT, and his Ph.D. in Economics from Harvard University. Dr. Gruber’s research focuses on the areas of public finance and health economics. He has published more than 140 research articles, has edited six research volumes, and is the author of Public Finance and Public Policy, a leading undergraduate text, and Health Care Reform, a graphic novel. In 2006 he received the American Society of Health Economists Inaugural Medal for the best health economist in the nation aged 40 and under. During the 1997-1998 academic year, Dr. Gruber was on leave as Deputy Assistant Secretary for Economic Policy at the Treasury Department. From 2003-2006 he was a key architect of Massachusettsâ€™ ambitious health reform effort, and in 2006 became an inaugural member of the Health Connector Board, the main implementing body for that effort. In that year, he was named the 19th most powerful person in health care in the United States by Modern Healthcare Magazine.
BookTV: Jonathan Gruber, “Health Care Reform: What It Is, Why It’s Necessary, How It Works
Jonathan Gruber, economics professor at the Massachusetts Institute of Technology and director of the health care program at the National Bureau of Economic Research, presents his thoughts on health care. Mr. Gruber a leading architect of Massachusetts’ health care reform also consulted with Congress and President Obama on the creation of the Affordable Care Act, signed into law by the President in 2010.
Obamacare architect Jonathan Gruber suddenly recast as bit player after uproar
Nancy Pelosi, fellow Democrats scramble to distance themselves from MIT professor, economist
For years, Massachusetts Institute of Technology professor Jonathan Gruber was deemed an architect of Obamacare and his economic modeling was cited regularly by the health care law’s defenders on Capitol Hill and in legal briefs defending the Affordable Care Act in federal courts.
But after tapes surfaced of the economist saying “stupid” voters needed to be bamboozled and the books cooked to get the legislation passed in 2010, Democrats are scrambling to reduce Mr. Gruber to a bit player — and raising questions about whether he needs to be expunged from their defense strategy as they face yet another Supreme Court review.
House Minority Leader Nancy Pelosi, who as speaker in 2009 posted an Obamacare “myth buster” citing Mr. Gruber, vehemently distanced herself from him Thursday.
“I don’t who he is. He didn’t help write our bill,” she said, but added that Mr. Gruber’s comments were a year old and he had recanted them.
In the comments that have just come to light, Mr. Gruber said the health care bill was written in a “tortured” way to ensure the Congressional Budget Office didn’t score the individual mandate as a tax, even though the U.S. Supreme Court ultimately upheld the mandate as constitutional under Congress’ taxing power.
“Lack of transparency is a huge political advantage,” Mr. Gruber said at the time. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get the thing to pass.”
Mr. Gruber said this week that he regretted the remarks. But House Speaker John A. Boehner, Ohio Republican, said Thursday that American voters are “anything but stupid” and oppose the health care system’s overhaul for valid reasons.
Mitch McConnell, the Kentucky Republican selected as the next Senate majority leader, said Mr. Gruber made a classic “Washington gaffe — when a politician mistakenly tells you what he really thinks.”
In legal briefs submitted last year to a federal district court in Virginia, Obama administration attorneys cited Mr. Gruber in a case defending their ability to pay subsidies to enrollees regardless of whether they are part of state-run or federally run health care exchanges.
“According to the calculations of one health care economist, without the minimum coverage provision and subsidized insurance coverage, premiums for single individuals would be double the amount anticipated under the ACA,” the Justice Department wrote in a legal brief last November, citing Mr. Gruber’s work in a footnote.
But Sam Kazman, general counsel for the Competitive Enterprise Institute, which is funding the administration’s opponents in the King case, said Mr. Gruber’s 2012 remarks about subsidies bolster their own arguments.
Mr. Gruber at the time said subsidies would flow only to states that set up their own exchanges.
“What’s important to remember politically about this is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits — but your citizens still pay the taxes that support this bill,” the economist told an audience.
That would mean consumers in most states wouldn’t be eligible for subsidies, which would puncture a big hole in Obamacare. The Obama administration has argued that even though the law says subsidies go to state exchanges, they also should include states that have opted for the federal exchange.
Mr. Kazman said the Gruber comments create a major problem for Mr. Obama.
“He’s not toxic to us,” Mr. Kazman said in an interview Thursday. “We may give him an award for public service.”
In a parallel case before the D.C. Circuit, the administration tried to downplay Mr. Gruber in its latest court filings. On Nov. 3, the Justice Department said in a footnote that “post-enactment statements by a non-legislator are entitled to no weight.”
“In any event, Professor Gruber has since clarified that the remarks on which plaintiffs rely were mistaken,” the attorneys told the D.C. Circuit, which has suspended its proceedings until the Supreme Court weighs in.
In the King case, Obama administration attorneys who cited Mr. Gruber in briefs at the lower court dropped him from their arguments to the Supreme Court, said Michael A. Carvin, an attorney for the health care law’s opponents.
He wasn’t about to let the justices forget.
“Tellingly,” Mr. Carvin said in a reply brief, “the government also ignores that Jonathan Gruber — the ACA architect whose work it cited in every brief below but is nowhere mentioned now — articulated the incentive purpose of [subsidies] as early as 2012.”
Mr. Gruber has made hundreds of thousands of dollars off Obamacare, serving as a consultant to the Department of Health and Human Services and to states that used health care grant money to pay him for his services.
Timothy Jost, a law professor at Washington and Lee University who closely tracks the health care law, said the controversy has been overblown.
“This whole thing just puzzles me,” he said. “He wasn’t a legislator. He didn’t write the bill. He didn’t vote on the bill.”
Transcending Obamacare: An Introduction To Patient-Centered, Consumer-Driven Health Reform
Today, the Manhattan Institute is publishing my 20,000-word, 68-page health reform proposal entitled “Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency.” It represents a novel approach to health reform: neither accepting Obamacare as is, nor requiring the law’s repeal to move forward. And yet its ambition is to permanently solve our health care entitlement problem, while also expanding coverage for the uninsured.
As most Apothecary readers know, I’ve long been critical of Obamacare, the so-called Affordable Care Act. The law expands Medicaid, the worst health insurance program in the developed world. It significantly drives up the underlying cost of health insurance for those who shop for coverage on their own. And regardless of what John Roberts has to say about it, Obamacare’s individual mandate—forcing most Americans to buy government-certified health coverage—is an injury to the Constitution.
But I’ve also long supported the principle of universal coverage. Universal coverage, done right, is a core part of a conservative worldview that values equality of opportunity for the sick and the poor. If 10 of the 11 freest economies in the world can establish universal coverage, it’s not impossible for the United States to do so in a way that is consonant with economic freedom.
Switzerland and Singapore: Market-based health reform models
The most market-oriented health care systems in the developed world—those ofSwitzerland and Singapore—have much to teach us about how to achieve universal coverage in a way that spends far less than what the U.S. does. In 2012, U.S. government entities spent $4,160 per capita on health care. That’s more than twice as much as Switzerland, and nearly five times as much as Singapore.
And that brings us right back to Obamacare. The vast majority of the law is misguided and misconceived. But a handful of its provisions can provide the basis of constructive health care reform: in particular, its use of Swiss-style means-tested tax credits to subsidize private health insurance premiums. Most importantly, those tax credits are applied to insurance plans that people shop for on their own, substantially expanding the market for individually purchased health coverage.
The Swiss system is far from perfect, as I have discussed on many occasions. But the basic idea in Switzerland is to offer premium subsidies to the people who really need them. In Switzerland, one-fifth of the population gets subsidized health coverage. In the U.S., around four-fifths do. That’s the difference between a safety net and an entitlement leviathan.
Conservative health reform after Obamacare
One of the fundamental flaws in the conservative approach to health care policy is that few—if any—Republican leaders have articulated a vision of what a market-oriented health care system would look like. Hence, Republican proposals on health reform have often been tactical and political—in opposition to whatever Democrats were pitching—instead of strategic and serious.
Those days must come to an end. The problems with our health care system are too great. Health care is too expensive for the government, and too expensive for average Americans.
In 2012, as the Romney campaign came to a close, Rich Lowry, the editor ofNational Review, asked me to write an article with my thoughts about the best path forward for conservative health care reform. I outlined a four-step plan to take the entire gamish of government health care programs and reform them into something consumer-driven and fiscally sustainable: (1) deregulate Obamacare’s insurance exchanges, including repeal of the individual mandate, while preserving guaranteed issue for individuals with pre-existing conditions; (2) migrate future retirees onto the reformed exchanges; (3) repeal Obamacare’s employer mandate; (4) migrate Medicaid acute-care and dual-eligible enrollees onto the exchanges.
“After these four relatively simple steps,” I wrote, “we would be left with a health-care system that would look a lot like Switzerland’s. Rises in premium subsidies could be held to a sustainable growth rate to ensure their long-term fiscal stability. And Americans might finally have the opportunity to purchase insurance for themselves, gain control of their own health-care dollars, and enjoy a wide range of low-cost, high-quality coverage options.”
A few months later, former Congressional Budget Office director Douglas Holtz-Eakin and I wrote a similar piece for Reuters, which elicited a broad range of responses from both the left and the right.
It became clear that I had to do more than write op-eds, that I had to develop this idea in detail, with credible fiscal and economic modeling.
Modeling market-based health reform
So, over the last 18 months, I’ve done just that. Stephen Parente, a health economist at the University of Minnesota, and his team modeled the fiscal and coverage impact of the bulk of my proposed set of reforms. (I then modeled the remainder, using analyses from the Congressional Budget Office, the Centers for Medicare and Medicaid Services, and the like.)
The Manhattan Institute for Policy Research, where I am a Senior Fellow, raised money to fund Parente’s work on this project. Steve and his team and I went back and forth for months, refining and tweaking the proposal until it met five non-negotiable goals. The end result had to:
- Reduce the deficit without raising taxes
- Expand coverage meaningfully above ACA levels
- Repeal the individual mandate
- Reduce the cost of private health insurance
- Improve health outcomes for the poor
Based on our modeling, the plan, over a thirty-year period, reduces federal spending by $10.5 trillion and federal revenue by $2.5 trillion, for a net deficit reduction of $8 trillion. We project that it will expand coverage by more than 12 million individuals over its first decade, despite the fact that it repeals the individual mandate. It reduces the cost of private-sector insurance policies by 17 percent for single policies and 4 percent for family policies.
But the most dramatic improvement, we estimate, is in the Medicaid population. A group that today receives substandard care and substandard access to care will see a dramatic increase in provider access and health outcomes, based on Parente-developed indices that measure these things.
Breaking free of the repeal-or-reform debate
Importantly, while this plan is compatible with “repealing and replacing” Obamacare, it does not require the repeal of Obamacare. To achieve the former, you would repeal Obamacare and replace it with a universal system of state-based health insurance exchanges. To achieve the latter, you’d reform the pre-existing ACA exchanges, and gradually migrate future retirees and Medicaid enrollees onto the reformed exchanges.
In this way, perhaps the plan can attract interest from both the right and the center.
We’ll soon find out.
Jonathan Gruber Embraced Misleading the Public About Obamacare Even While It Was Still Being Debated
In the week since video surfaced of Obamacare architect Jonathan Gruber saying that “lack of transparency” and “the stupidity of the American voter” were critical to passing the health law, two more videos of Gruber making statements with similar themes or tones have received attention.
Both clips reveal a gleefully dismissive attitude toward public concerns about the law, and offer a telling reminder of the attitude that played a crucial role in shaping and selling the law to the public.
In the first video, recorded in March of 2010, just a few days before the law would pass the House, Gruber argues that the public does not really care about the uninsured. What it cares about is cost control. Therefore, he says, the law had to be sold on the basis of its cost control.
Yet as Gruber admits in the video, the bill was not primarily focused on cost control—the bill “is 90% health insurance coverage and 10% about cost control.” Indeed, the problem with cost control, he says, is that “we don’t know how” to do it.
The primary quote. Via CNN:
“Barack Obama’s not a stupid man, okay?” Gruber said in his remarks at the College of the Holy Cross on March 11, 2010. “He knew when he was running for president that quite frankly the American public doesn’t actually care that much about the uninsured….What the American public cares about is costs. And that’s why even though the bill that they made is 90% health insurance coverage and 10% about cost control, all you ever hear people talk about is cost control. How it’s going to lower the cost of health care, that’s all they talk about. Why? Because that’s what people want to hear about because a majority of American care about health care costs.”
Elsewhere in the same speech, Gruber says:
“The only way we’re going to stop our country from being a latter day Roman Empire and falling under its own weight is getting control of the growth rate of health care costs. The problem is we don’t know how.”
Remember, this is what Gruber was saying as the law was still being debated. It didn’tpass in the House, the critical step before hitting President Obama’s desk, until more than a week later. And what Gruber was saying, even before the bill was law, was that supporters had intentionally emphasized parts of the bill that were relatively minor, and that were not certain to even produce their intended effects.
This is not lying, exactly; the bill did in fact include some attempts at cost control, although as Gruber said, it was unclear at the time if or how well they would work. And Gruber may well have been right that the public was more concerned with cost control than expanding coverage. But, especially in combination with the other video released this week, it indicates that Gruber believed that the law’s advocates were not being completely straight with the public, that supporters of Obamacare were telling the public what they believed the public wanted to hear instead of giving them the full story, and that they were doing so on the understanding that telling the full story would make the bill impossible to pass.
What it shows, in other words, is Gruber openly embracing a strategy of messaging manipulation and misleading emphasis even while the bill was still being debated. If the public understood the bill clearly, he believed, they would reject it. It was more important to pass the bill.
Another video, posted today by The Daily Signal, shows Gruber taking a similarly dismissive attitude toward public concerns about the bill. At a meeting with the Vermont House Health Care Committee, Gruber is presented with a question about whether systems like those described in a report by Gruber and Harvard health economist William Hsiao, might result in “ballooning costs, increased taxes and bureaucratic outrages” as well “shabby facilities, disgruntled providers” and destructive price controls.
Gruber’s response begin with: “Was this written by my adolescent children by any chance?” The Signal quotes two-term Vermont state senator and Reagan-adviser John McClaughry as saying that the question had been submitted “by a former senior policy adviser in the White House who knew something about health care systems.”
Gruber’s response is intended as a joke, and it reveals little about the health care law (the reforms in question are specific to Vermont). But it says plenty about Gruber, and the flippant, arrogant way he treats concerns and criticism.
This is the person whom the White House relied on to help craft the bill; he was paid handsomely to model its effects (a fact he did not disclose, even when asked), and he was in the room when important decisions were made about how it would work. He claims to have helped write specific portions of the law himself. Gruber was not the sole architect of the law, but he was one of its biggest single influences on both its design and on how the media, which quoted him repeatedly, reported and understood the law.
The White House and its allies are desperately trying to distance themselves from Gruber right now by downplaying his role in the law’s creation. But the record of his involvement is clear enough: At The Washington Post, Ezra Klein has variously described Gruber as “one of the key architects behind the structure of the Affordable Care Act” and “the most aggressive academic economist supporting the reform effort.” The New York Times in 2012 described his role as helping to design the overall structure as well as being “dispatched” by the White House to Congress to write the legislative text. Gruber’s work was cited repeatedly by the White House, Democratic leadership, and the media.
So when he describes the thinking about how the law was crafted and sold to the public, it’s worth taking note. This is the posture of one of the law’s authors and chief backers. It’s part of the spirit in which the law was created and passed. Gruber’s ideas were embedded in the law’s structure and language, and so was his attitude.
White House says Gruber’s wrong, attacks GOP
By LUCY MCCALMONT
The White House is denouncing comments from key Obamacare architect Jonathan Gruber that a lack of transparency and the stupidity of voters helped in the passage of the health care law and is instead pointing a finger at Republicans.
“The fact of the matter is, the process associated with the writing and passing and implementing of the Affordable Care Act has been extraordinarily transparent,” White House press secretary Josh Earnest said during a news briefing in Myanmar, according to a transcript provided by the White House.
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“I disagree vigorously with that assessment,” Earnest responded when asked about Gruber’s claim that Obamacare wouldn’t have passed if the administration was more transparent and voters more intelligent.
He added, “It is Republicans who have been less than forthright and transparent about what their proposed changes to the Affordable Care Act would do in terms of the choices are available to middle class families.”
Earnest said the president “is proud of the transparent process that was undertaken to pass that bill into law.”
The response from the White House comes as a third video of Gruber criticizing the intelligence of American voters has surfaced.
“We just tax the insurance companies, they pass on higher prices that offsets the tax break we get, it ends up being the same thing. It’s a very clever, you know, basic exploitation of the lack of economic understanding of the American voter,” Gruber said in remarks from 2012 that aired Wednesday evening on “On the Record with Greta Van Susteren.”
Gruber has been causing headaches for the White House as conservatives have had a field day that began with comments the MIT professor made in 2013.
“Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter, or whatever, but basically that was really, really critical for the thing to pass,” Gruber said at the time, according to one of the videos that has recently come to light.
In another video clip of a separate event, while talking about tax credits in the Affordable Care Act, he said, “American voters are too stupid to understand the difference.”
Gruber apologized for the comments during an appearance earlier this week on MSNBC’s “Ronan Farrow Daily”:
(Also on POLITICO: Ted Cruz out on a limb on Obamacare repeal)
“I was speaking off the cuff, and I was basically speaking inappropriately, and I regret having made those comments.”
Meanwhile, House Minority Leader Nancy Pelosi dismissed Gruber’s role in Obamacare on Thursday, telling the press, “I don’t know who he is. He didn’t help write our bill.”
Many outlets were quick to point out that Pelosi cited Gruber in a “Health Insurance Reform Mythbuster” on her official website in 2009.
House Speaker John Boehner released a statement Thursday, slamming Gruber for his comments.
“If there was ever any doubt that ObamaCare was rammed through Congress with a heavy dose of arrogance, duplicity, and contempt for the will of the American people, recent comments by one of the law’s chief architects, Jonathan Gruber, put that to rest,” the top Republican said.
The statement continues, “The American people are anything but ‘stupid.’ They’re the ones bearing the consequences of the president’s health care law and, unsurprisingly, they continue to oppose it.”
Cadillac insurance plan
|Health care reform in the United States|
|Third-party payment models|
Informally, a Cadillac plan is any unusually expensive health insurance plan, usually arising in discussions of medical-cost control measures in the United States. The term derives from the Cadillac automobile, which has represented American luxury since its introduction in 1902, and as a health care metaphor dates to the 1970s. The term gained popularity in the early 1990s during the debate over the Clinton health care plan of 1993, and was also widespread during debate over possible excise taxes on “Cadillac” plans during the health care reforms proposed during the Obama administration. (Bills proposed by Clinton and Obama did not use the term “Cadillac”.)
The Patient Protection and Affordable Care Act (as amended by the Health Care and Education Reconciliation Act of 2010) imposes an annual 40% excise tax on plans with premiums exceeding $10,200 for individuals or $27,500 for a family (not including vision and dental benefits) starting in 2018.
Criticisms of these plans generally center on the small or nonexistent co-pays, deductibles, or caps that encourage the overuse of medical care, driving the cost up for the uninsured or those on other plans, which some say necessitates aCadillac tax.
A study published in Health Affairs in December 2009 found that high-cost health plans do not provide unusually rich benefits to enrollees. The researchers found that only 3.7% of the variation in the cost of family coverage in employer-sponsored health plans is attributable to differences in the actuarial value of benefits. Only 6.1% of the variation is attributable to the combination of benefit design and plan type (e.g., PPO, HMO, etc.). The employer’s industry and regional variations in health care costs explain part of the variation, but most is unexplained. The researchers conclude “…that analysts should not equate high-cost plans with Cadillac plans, but that in fact other factors—industry and cost of medical inputs—are as important in predicting whether a plan is a high-cost plan. Without appropriate adjustments, a simple cap may exacerbate rather than ameliorate current inequities.”
- Beam, Christopher (2009-10-14). “Do I have a “Cadillac Plan”? An Explainer health care FAQ”. Slate.
- Abelson, Reed (2009-09-20). “A Tax on Cadillac Health Plans May Also Hit the Chevys”. New York Times.
- Hit, Greg (2009-09-26). “House Weighs ‘Cadillac-Plan’ Tax”. Wall Street Journal.
- Gold, Jenny (2010-01-15). “‘Cadillac’ Insurance Plans Explained”. Kaiser Health News.
- Jon Gabel, Jeremy Pickreign, Roland McDevitt, and Thomas Briggs, “Taxing Cadillac Health Plans May Produce Chevy Results,” Health Affairs, web exclusive, Published online December 3, 2009, doi:10.1377/hlthaff.2008.0430
- Understanding the Health Care Excise Tax, The Bottom Line (Committee for a Responsible Federal Budget)
- Cost of the Finance Committee Health Care Bill
How ObamaCare Taxes Affect You: New Taxes, Hikes, Breaks, Credits, and Other Changes
Here’s a full list of ObamaCare Taxes. The 21 new ObamaCare tax hikes and breaks impact us all, but which ObamaCare taxes will you actually pay? Find out how the tax related provisions in the Affordable Care Act (ObamaCare) will affect you, your family, your business, and your tax returns for 2013 and beyond.
The Bottom Line on the ObamaCare Tax Plan
The new tax related provisions in theAffordable Care Act(ObamaCare) include tax hikes, limits to deductions, tax credits, tax breaks, and other changes. While a few of the changes directly affect the average American, tax increases primarily affect high earners (those making over $200,000 as an individual or $250,000 as a family), large businesses (those making over $250,000), and the health care industry, while tax credits primarily affect low-to-middle income Americans and small businesses.
Here are some quick facts to help you understand how ObamaCare affects taxes:
• For the majority of the 85% of Americans with health insurance the percentage of income paid in taxes won’t change much, if at all. However, some of the changes may directly or indirectly affect specific groups.
• The majority of the 15% of Americans without health insurance will primarily be affected by the Individual Mandate (the requirement to buy health insurance), the Employer Mandate (the requirement for large employers to insure full-time employees), and Tax Credits (tax credits reduce premium costs for individuals, families, and small businesses).
• Many Americans will be affected by changes to new limits on medical tax deduction thresholds MSAs, FSAs, and HSAs.
• Small businesses will not be required to provide health insurance, but will gettax credits to reduce premium costs if they choose to offer group plans.
• Even if you won’t see higher taxes under the Affordable Care Act, it doesn’t mean there aren’t costs associated with the law. You’ll still need to buy health insurance, unless you qualify for Medicaid or an exemption, and that will cost you money.
• As a rule of thumb those who make less pay less and those who make more pay more, both in regard to health insurance costs and taxes under theAffordable Care Act.
• The Congressional Budget Office has shown that the revenue generated from the new taxes, along with cuts to spending, will help to pay for the Affordable Care Act’s many provisions, fund tax credits and lower the deficit by 2023.Learn More.
Why Does ObamaCare Create New Taxes?
ObamaCare includes many new benefits, rights, and protections including the requirement for health insurers to cover people with pre-existing conditions. It also expands access to affordable health insurance to almost 50 million low-to-middle income men, women, and children across the country by offering reduced premiums via tax credits and expanding Medicaid and CHIP. Expanding the quality, affordability and availability of health insurance (along with other aspects of the law) come at a high cost. Assuming all tax provisions remain in place, the revenue generated from these new taxes help to cover the costs of the program and reduces the deficit. Learn more about the new benefits, rights, protections offered by the Affordable Care Act.
A Quick Overview of Key Taxes in the Affordable Care Act
Before we get to the full list of taxes here is a quick overview of the key tax related provisions that may affect those without insurance, those who plan to go without insurance, and those who are struggling to afford insurance now.
Individual Mandate (new tax): Americans who can afford to must obtain minimum essential health coverage for 2014, get an exemption or pay a per month fee.
Employer Mandate (new tax): Come 2015 large employers must insure full time employees or pay a per employee fee. Over half of Americans get their insurance through work and the largest group of uninsured is currently the working poor.
Advanced Premium Tax Credits (tax break): Low-to-middle income Americans are eligible for tax credits which reduce the upfront cost of premiums on health insurance purchased through their State’s “Health Insurance Marketplace”.
Taking all the tax provisions in the ACA into account ObamaCare technically provides the greatest middle class tax cut to healthcare in history.
Full List of All Taxes in ObamaCare / All Taxes in the Affordable Care Act
The following list of new ObamaCare taxes collectively raise over $800 billion by 2022. Here is a complete list of new fees and taxes contained withinObamaCare:
ObamaCare Taxes That Most Likely Won’t Directly Affect the Average American
• 2.3% Tax on Medical Device Manufacturers 2014
• 10% Tax on Indoor Tanning Services 2014
• Blue Cross/Blue Shield Tax Hike
• Excise Tax on Charitable Hospitals which fail to comply with the requirements of ObamaCare
• Tax on Brand Name Drugs
• Tax on Health Insurers
• $500,000 Annual Executive Compensation Limit for Health Insurance Executives
• Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
• Employer Mandate on business with over 50 full-time equivalent employees to provide health insurance to full-time employees. $2000 per employee $3000 if employee uses tax credits to buy insurance on the exchange (marketplace). (pushed back to 2015)
• Medicare Tax on Investment Income 3.8% over $200k/$250k
• Medicare Part A Tax increase of .9% over $200k/$250k
• Employer Reporting of Insurance on W-2 (not a tax)
• Corporate 1099-MISC Information Reporting (repealed)
• Codification of the “economic substance doctrine” (not a tax)
ObamaCare Taxes That (may) Directly Affect the Average American
• 40% Excise Tax “Cadillac” on high-end Premium Health Insurance Plans 2018
• An annual $63 fee levied by ObamaCare on all plans (decreased each year until 2017 when pre-existing conditions are eliminated) to help pay for insurance companies covering the costs of high-risk pools.
• Medicine Cabinet Tax
Over the counter medicines no longer qualified as medical expenses for flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), health savings accounts (HSAs), and Archer Medical Saving accounts (MSAs).
• Additional Tax on HSA/MSA Distributions
Health savings account or an Archer medical savings account, penalties for spending money on non-qualified medical expenses. 10% to 20% in the case of a HSA and from 15% to 20% in the case of a MSA.
• Flexible Spending Account Cap 2013
Contributions to FSAs are reduced to $2,500 from $5,000.
• Medical Deduction Threshold tax increase 2013
Threshold to deduct medical expenses as an itemized deduction increases to 10% from 7.5%.
• Individual Mandate (the tax for not purchasing insurance if you can afford it) 2014
Starting in 2014, anyone not buying “qualifying” health insurance must pay an income tax surtax at a rate of 1% or $95 in 2014 to 2.5% in 2016 on profitable income above the tax threshold. The total penalty amount cannot exceed the national average of the annual premiums of a “bronze level” health insurance plan on ObamaCare exchanges.
• Premium Tax Credits for Small Businesses 2014 (not a tax)
• Advanced Premium Tax Credits for Individuals and Families 2014 (not a tax)
• Medical Loss Ratio (MRL): Premium rebates (not a tax)
The link below provides a full list of ObamaCare Taxes by the IRS.
Or see the latest publication by the joint tax committee on the Affordable Care Act.
Who Does ObamaCare Tax?
Let’s take a look at how ObamaCare’s taxes affect certain income groups.
ObamaCare Taxes for High Earners and Large Businesses
Most of the new taxes are on high-earners (individuals making over $200,000 and families making over $250,000), large businesses (over 50 full-time equivalent employees making over $250,000), and industries that profit from healthcare. Essentially those who will see gains under ObamaCare are required to put money back in the program via taxes.
FACT: Tax increases generally affect single filers with an adjusted gross income (AGI) above $200,000 and married couples filing jointly above $250,000. Some of the tax increases don’t kick in until single AGI hits $400,000 and married filing jointly AGI hits $450,000.
ObamaCare Taxes for the Average American With Health insurance
For most of the 85% of Americans with health insurance, making less than $250,000, most of the new taxes won’t mean much of anything although certain taxes below will affect specific individuals and families.
ObamaCare Taxes for the Average American Without Health insurance
The 15% of Americans without health insurance will be required to obtain health insurance (Individual Mandate) or will face a “tax penalty”.
The good news is that many uninsured will be exempt from the Individual mandate due to income, offered cost assistance through the marketplaceincluding Tax Credits (also available to small businesses), qualify for Medicaid, or will get insurance through work (the Employer Mandaterequires large employers to insure full-time employees by 2015). Adults who are under 26 will be able to stay on their parents plan as well, this will help to limit the number of young people who will pay the fee. Both the employer and individual mandates are part of our “shared responsibility” to expand the quality and affordability of health insurance in the United States as a trade for our new benefits, rights and protections.
ObamaCare Taxes for Small Businesses
Small businesses with less than 25 full-time equivalent employees will have access to tax credits to reduce premium costs of group plans.
ObamaCare Taxes for Specific Groups With Health Insurance
Here are a few changes that my affect specific groups of Americans with health insurance:
• Other tax provisions such as changes medical deduction thresholds, HSAs, MSAs, and FSAs may impact some Americans by limiting tax deductions.
• The Medical Loss Ratio (MLR or 80/20 rule) will mean that some Americans may get rebates if health insurance companies spend on non-healthcare related expenses.
• Tax provisions like the 10% tanning bed tax, taxes on drug companies, taxes on medical devices and taxes on health insurance companies selling insurance on and off the exchange may affect the amount of money we pay for some health care related goods and services, but will not have a significant impact on our daily lives.
• The employer mandate has caused some companies to cut down full-time workers to part-time to avoid providing benefits, however major employers like Disney and Walmart have actually increased their full-time workforce in response to the looming 2015 deadline.
• Overall the benefits tend to outweigh the costs for the average American as even those who pay a little more, get a lot more in return due to the increased quality of their health insurance.
Will I pay More Taxes and High Premiums Because of ObamaCare?
As mentioned above premium rates and the taxes you will have to pay are primarily based on income. Aside from income premium prices are based on which plan you choose, family size, age, smoking status and geography. Subsidies reduce the overall rate of your premiums (however smoking is calculated after subsidies). Come 2018 there will be a 40% excise tax on high end health insurance plans.
Aside from the tax provisions that require Americans to obtain insurance and subsidize it’s costs, ObamaCare also includes a few tax related provisions that work as consumer protections including requirements for better reporting and the Medical Loss Ratio.
ObamaCare Tax Rebates
Some consumers in both individual and group markets will see tax rebates due to ObamaCare’s Medical Loss Ratio (MLR). Health insurance companies will have to provide rebates to consumers if they spend less than 80 to 85% of premium dollars on medical care.
Medical Loss Ratio (MLR)
The Medical Loss Ratio (MLR) means that Insurance companies are now required to spend at least 80% of premium dollars (85% in large group markets) on medical care and quality improvement activities. Insurance companies that are not meeting this standard will be required to provide rebates to their consumers. The MLR isn’t a tax, but it does have implications in regards to filing taxes and rebates can be given in the form of reduced premiums. See our page on ObamaCare Health Insurance Regulations for more details.
ObamaCare Income Tax Penalty For Not Having Insurance “Individual Mandate”
Starting in 2014, most people will have to have insurance or pay a “penalty deducted from your taxable income”. For individuals, penalty starts at $95 a year, or up to 1% of income, whichever is greater, and rise to $695, or 2.5% of income, by 2016.
For families the tax will be $2,085 or 2.5% percent of household income, whichever is greater. The requirement can be waived for several reasons, including financial hardship or religious beliefs. If the tax would exceed 8% of your income you are exempt, also some religious groups are exempt. That tax cannot exceed the cost of a “bronze plan” bought on the exchange.
Many individuals who are exempt from the mandate to buy insurance will still be eligible for free or low-cost insurance through the health insurance marketplace.
While some states, including Alabama, Wyoming and Montana, have passed laws to block the requirement to carry health insurance, those provisions do not override federal law. Get more information on the ObamaCare Individual Mandate.
The Individual Mandate is officially called the “individual shared responsibility provision”.
What Are ObamaCare Tax Credits?: Advanced Premium Tax Credits
Premium tax credits are a form of cost assistance that reduce premium costs for coverage purchased on your State’s “health insurance marketplace” for individuals, families, and small businesses.
Advanced Premium Tax Credits for Individuals and Families
Individuals and families will have access to Advanced premium tax credits on the marketplace. Tax Credits are deducted from your premium cost by your health insurance provider and are adjusted on your Modified Adjusted Gross Income (MAGI). You can choose how much advance credit payments to apply to your premiums each month, up to a maximum amount. If the amount of advance credit payments you get for the year is less than the tax credit you’re due, you’ll get the difference as a refundable credit when you file your federal income tax return. If your advance payments for the year are more than the amount of your credit, you must repay the excess advance payments with your tax return.
Aside from premium tax credits individuals and families can also get lower cost sharing on out-of-pocket expenses like coinsurance, copays, deductibles and out-of-pocket maximums through the marketplace.
Eligibility for Tax Credits
In general, you may be eligible for the credit if you meet all of the following:
- buy health insurance through the Marketplace;
- are ineligible for coverage through an employer or government plan;
- are within certain income limits;
- file a joint return, if married; and
- cannot be claimed as a dependent by another person.
If you are eligible for the credit, you can choose to:
- Get It Now: have some or all of the estimated credit paid in advance directly to your insurance company to lower what you pay out-of-pocket for your monthly premiums during 2014; or
- Get It Later: wait to get all of the credit when you file your 2014 tax return in 2015.
How Will Advanced Premium Tax Credits Affect My Health Insurance Costs?
Under the Affordable Care Act health insurance that costs less than 8% of your MAGI is considered affordable. Although the law doesn’t guarantee lower costs, premium tax credits help to ensure that more Americans will have access to affordable insurance.
s a rule of thumb most Americans will pay between 1.5% and 9.5% on their Modified Adjusted Gross Income (MAGI) when using tax credits to buy a basic Silver Plan on the marketplace.
If the lowest-priced coverage available to you would cost more than 8% of your household income are exempt from the individual mandate.
The amount you pay is on a sliding scale based on your income. Use the chart below to get an idea of what you and your family may pay for insurance purchased through the Health Insurance Marketplace. Make sure to check outObamaCare Subsidies for more detailed information on Premium Tax Credits.
The 2013 Federal Poverty Level Guidelines below are used to Determine if your percentage of the poverty level for both taxes and cost-assistance.
For each additional person, add
This following table is an example of how premium tax credits work. Please note that the numbers below are purely for example and don’t reflect your personal rates.
|Income % of federal poverty level||Premium Cap as a Share of Income||Income $ (family of 4)||Max Annual Out-of-Pocket Premium||Premium Savings||Additional Cost-Sharing Subsidy|
|133%||3% of income||$31,900||$992||$10,345||$5,040|
|150%||4% of income||$33,075||$1,323||$9,918||$5,040|
|200%||6.3% of income||$44,100||$2,778||$8,366||$4,000|
|250%||8.05% of income||$55,125||$4,438||$6,597||$1,930|
|300%||9.5% of income||$66,150||$6,284||$4,628||$1,480|
|350%||9.5% of income||$77,175||$7,332||$3,512||$1,480|
|400%||9.5% of income||$88,200||$8,379||$2,395||$1,480|
|In 2016, the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four. Use the Kaiser ObamaCare Cost Calculator for more information. DHHS and CBO estimate the average annual premium cost in 2014 to be $11,328 for family of 4 without the reform. Source: Wikipedia|
ObamaCare Employer / Employee Taxes
ObamaCare’s taxes mean large employers will have to provide health insurance to their employees and will see a raised Medicare part A tax, small businesses may be eligible for tax breaks.
Medicare part A Tax Hike for Employers and Employees
The Medicare part A tax is paid by both employees and employers who earn over a certain amount. ObamaCare’s Medicare tax hike is a .9% increase (from 2.9% to 3.8%) on the current total Medicare part A tax. This tax is split between the employer and employee meaning that they will both see a .45% raise. Small businesses making under $250,000 are exempt from the tax. Employees making less than $200,000 as an individual or ($250,000) as a family are also exempt. Employers must withhold and report an additional 0.9 percent total on employee wages or compensation that exceed $200,000.
Tax Penalty for Not Providing Full-time Workers with Health Insurance the “Employer Mandate”
Employers with over 50 full-time equivalent employees must either insure their full-time employees or pay a penalty or “employer shared responsibility fee”. The penalty is $2000 per employee. If however, at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.
Employers with under 25 full time employees, whose average income doesn’t exceed $50,000, can apply for tax credits of up to 50% for insuring their employees.
Tax Credits for Small Businesses
Small businesses with under 25 full-time equivalent employees with average annual wages of less than $50,000 can apply for tax breaks of up to 50% of their share of employee premium costs via ObamaCare’s Small Business Health Options Program (accessible through your State’s Health Insurance Marketplace). The credit can be as much as 50% of employer premiums (35% for not-for-profits in 2014). The credit is only available if the employer is paying at least 50% of the total premiums.
Small Business Health Options Program
Employers with 50 or fewer employees, you can purchase affordable insurance through the Small Business Health Options Program (SHOP) even if they don’t qualify for tax credits.
Along with the new law there are new requirements for reporting.
- Effective for calendar year 2015, you must file an annual return reporting whether and what health insurance you offered your employees. This rule is optional for 2014. Learn more.
- Effective for calendar year 2015, if you provide self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover. This rule is optional for 2014. Learn more.
- Beginning Jan. 1, 2013, you must withhold and report an additional 0.9 percent on employee wages or compensation that exceed $200,000. Learn more.
- You may be required to report the value of the health insurance coverage you provided to each employee on his or her Form W-2.
Other ObamaCare Taxes on Big Business
Aside from having to adhere to the “employer mandate” ObamaCare also imposes taxes and fees that are unique to big business. ObamaCare taxes some medical device manufactures, drug companies and health insurance companies. Beginning in 2013, medical device manufacturers and importers must pay a 2.3% tax on the sale of a taxable medical device. This raises $29 billion over a 10 years. However, many states are asking to delay the medical device excise tax to protect jobs in states that produce the devices. An annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion.
- Employers that have employees who earn more than $200,000 will have to look at the potential for additional Medicare withholding due to the Medicare part A tax.
- Employers that issued 250 or more W-2 forms in 2012 must report the cost of employer-sponsored health coverage for 2013 on the 2013 W-2 forms.
Medical Device Excise Tax
There is a 2.3% medical excise tax on medical device manufacturers and importers on the sale of taxable medical devices. Section 4191 of the Internal Revenue Code imposes an excise tax on the sale of certain medical devices by the manufacturer or importer of the device. The tax applies to sales of taxable medical devices after Dec. 31, 2012. You can learn more from the official IRS page on the Medical Device Tax.
What Increases Do the ObamaCare Taxes Include for The $200k/$250k Earners?
ObamaCare Medicare Part A Payroll Tax
Starting in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 will see an increase in the Medicare part A payroll tax. It’s an increase of 2.35%, up from the current 1.45% ( a .9% Medicare part A payroll tax hike), on adjusted income over the threshold.
ObamaCare Unearned Income Tax
This group will also pay a 3.8% unearned income (capital gains) tax on interest, dividends, annuities, royalties, rents, and gains on the sale of investments over the threshold.
Taxable income under the $200,000 for individuals and $250,000 threshold for families is subject to the same benefits and tax cuts as those who make under the threshold.
ObamaCare Home Sales Tax / ObamaCare Real Estate Tax Increase
ObamaCare increases taxes on unearned income by 3.8% and this can add additional taxes to the sales of some homes, but many limitations apply which means it won’t affect most sellers. The 3.8% capital gains tax typically doesn’t apply to your primary residence. It also doesn’t usually apply to homes you have owned for over 5 years or on profits of less than $250,000 for individuals and $500,000 for couples due to a capital gains tax exclusion rule for sales of a primary home.
In short the ObamaCare home sales tax isn’t something that most of us will pay, it is a tax is aimed at those selling non-primary residences in short term periods for profit and not at the average American buying and selling their primary residence.
ObamaCare Medical Expense Deductions
ObamaCare increases the medical expense deduction threshold. Unreimbursed medical expense deductions will now be available only for those medical expenses in excess of 10% of AGI, which has been raised from 7.5%. There is a temporary exemption for individuals ages 65 and older and their spouses from 2013 through 2016.
ObamaCare “Cadillac” Tax
Starting in 2018, the new health care law imposes a 40% excise tax on the portion of most employer-sponsored health coverage (this excludes dental and vision) that exceed $10,200 a year and $27,500 for families. The tax has been dubbed a “Cadillac” tax because it hits only high-end “gold”, “platinum” and high-end health care plans not purchased on the exchange. The tax raises over $150 billion over the next 10 years.
New ObamaCare Taxes Summary
Going through the new ObamaCare taxes line by line is, in itself, taxing. The bottom line is that a majority of Americans will find themselves paying less for better healthcare, while higher-earners will pay tax rates closer to what they did in the Clinton years. ObamaCare pays for most of itself via the above taxes, reforms to Medicare, and health care as a whole, as well as cutting out billions in wasteful spending.
ObamaCare Taxes Moving Forward into 2014
We hope this helps you to understand the new ObamaCare taxes and how they work. Many of the ObamaCare’s taxes won’t be fully implemented until 2022, but most will be in effect by 2014. ObamaCare helps all Americans get access to quality affordable healthcare, and new benefits, rights and protections. Make sure to look out for ObamaCare tax breaks, credits, subsidies and breaks on up front costs moving forward into 2014. As we learn more we will update our full ObamaCare tax list.
ObamaCare Taxes: New Health Care Taxes
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