Despite unified recommendations from 101 economists, reminiscent of service puppies for public administrators, the 2018 Cadillac Tax has been deferred to 2020. Among these economists was 2015 Nobel Prize winner Angus Deaton. The opening statement from health economists and policy analysts, addressing senators and representatives, cited the unlimited exclusion from income and payroll taxes as being economically inefficient and regressive. The statement concluded that without the Cadillac Tax, government subsidized healthcare would be inevitable.
General public criticism of the Cadillac Tax is that more Americans will be uninsured. However, professional analysis by Moody’s Investor Services indicates that healthcare payer participation will increase as a result of the Cadillac Tax.
As the tax reads, individuals and employers not moving to lower-cost plans will be progressively included into a 40% tax rate. However, the tax is not designed to raise revenues to cover healthcare costs, it is designed to influence greater participation in lower-cost plans which reduces premiums and overall healthcare costs. These reductions allow participation from uninsured individuals, effectively reducing healthcare costs twice.
Without the Cadillac Tax’s design (lower-cost plans and increased participation), healthcare costs will inflate at least $4000 by 2028. In 2013, per capita healthcare expenditures were over $9000, when the poverty line income was only double that amount. That same year, 14.5% of Americans were impoverished. Greater participation from this group, first quintile earners, is necessary to reduce inflationary costs attributed to low participation and bad-debt, of which the latter efficiently increases both direct costs and premiums.
Third through fifth quintile earners in high-cost plans must shift to low-cost plans in order to increase affordability for first quintile earners and their participation. The reason for this, as previously explained, is to prevent the $4000 increases on current participants which would effectively reduce payer participation.
The Cadillac Tax, as noted by the economists, will remove healthcare Flexible Spending Accounts (FSAs) from healthcare plans. FSAs, generally owned by third through fifth quintile earners, act as a government subsidized savings accounts. FSAs are tax free, a $750 savings per year, and allow for accrual of interest to providers. This regressively pays upper quintile earners for having money in the FSA, especially when compared to a traditional savings account ($25 earned per year). Neither of these accounts are likely owned by the uninsured, notably the lower quintile earners, and the savings from FSAs will be outpaced by inflationary increases.
The Cadillac Tax allows the stability designed within the Affordable Care Act to progress efficiently and to non-governmentally finance healthcare. Financing affordable healthcare has been generationally deferred. As the 2020 deadline approaches, and with 80% of Boomers having insufficient financing for healthcare, this is undoubtedly the reason economists implore the U.S. to provide more affordable healthcare.