House Votes to Repeal Obamacare Tax Once Seen as Key to Health Law

Jul 17, 2019 · 484 comments
Juvenal451 (USA)
"...high-cost, generous health insurance plans..." Seems to an oxymoron, If the plans are high cost, their benefits are not generous.
Hedonikos (Washington)
“Passage of this bill will lift the shadow that overhangs employer-sponsored plans and stop the high deductible trend from worsening,” Courtney said Wednesday afternoon before the vote. “I am hopeful an overwhelming tally tonight will send a laser light message to the Senate to adopt this bill as soon as possible.” As a Healthcare provider I can only think this Congressman, like most Americans drawing high salaries, are deaf and dumb. While I understand that this probably needed to be repealed, there is one immutable fact about our healthcare system. Deductibles will continue to increase regardless. This isn't about helping the middle class as it won't. We are still going to see increase in our deductible and our premiums. It is capitalism. Irresponsible capitalism. I can guarantee that.
Eleanor (Augusta, Maine)
Some day we will have universal health care-once the electorate realizes the insurance companies and bif pharma are the only ones happy with the current "system". Ih, and the politicians the profitable companies support.
Kevin (Rhode Island)
And next on the democrats legislative agenda is raising the minimum wage to 15 dollars an hour. The could have raised it when Obama was president, but healthcare for all was more important and raising the minimum wage only effected the least fortunate, who somehow tend to vote republican anyway. As democrats join in its dismantling, one has to wonder what was so important. Time for citizen democrats to join the republican party, or walk straight into the ocean.
Michael Blazin (Dallas, TX)
Contrary to some thought, most people like their private health insurance. I managed my mother’s Medicare plans and bills. While Medicare is better than no health plan, it is not as good as private. I doubt that LBJ et al ever intended it to be. This particular fight gives politicians a tiny view into the fight that will happen if private health plans are forced to close or doctors are forbidden from selling services to anyone but the government. That last little gem was actually in one version of the many health bills filed in this session. Truly asinine.
Kevin (Rhode Island)
Where is the analysis of who is most effected by this Cadillac tax? I suspect it is the upper middle class tax payer "poor baby" whose tax burden is greater than the rest. This does not justify democrat politicians betraying democrat voters.
John H (Fort Collins, CO)
I often wonder whether those who find "Medicare for All" so attractive have thought about the consequences. First, I have heard little discussion about where the money will come from, apart from vague statements about "greater efficiency" and "lower costs." The simple fact is that the money will come from us, as the government has no other source of revenue. This leads to the second and more distressing consequence, the notion that we would be handing the government responsibility for about 16% of the GDP. I often encourage people to think of the things that the government does well. I can think of two: national defense and interstate highways.
mark (pa)
Read my lips: "over utilization is the problem in American healthcare." Not greedy doctors/hospitals/pharma. If by government regulation people mean regulating use, then OK. If you mean that the government can magically lower the price of healthcare so most people can continue having everything imaginable, then no it will not work. Consider what would happen if everyone could demand a house as a basic right. That is what the inside of healthcare in the US looks like today.
frank monaco (Brooklyn NY)
So where do we go from here? What is the Plan going forward? Republicans never came up with a real plan just vouchers. No one wants to be taxed but sure will take a government program. Tax is how the Govenment gets money to get things done. I don't believe a real health bill that will provide Medical Coverage to all Americans will ever get passed in my life time. But we will always find money for a WAR.
Sari (NY)
The GOP has been carrying on about getting rid of the Affordable Care Act, however they have yet to propose anything as a replacement. What we don't need is a socialist who wants medicare for all. There are those who do not want to give up their private insurance and they must be respected.
LH (Beaver, OR)
ObamaCare came about as the result of compromise. While the goals were laudable, we ended up with a proverbial square peg in a round hole. Perhaps the biggest failure has been the complexity of the new system along with mandates and huge administrative costs. Unfortunately, it appears we are now tearing up the system without considering a meaningful alternative. It's no wonder so many people are losing faith in both republicans and democrats.
Gregory West (Brandenburg, Ky.)
The Walter Cronkite Republican hopes the nation will now focus on the exorbant proportion of health care costs that can be attributed to "middle men" who attempt to manage medicine without any training in medicine. Ignorance is not the same thing as "thinking outside the box".
rixax (Toronto)
Am I missing something? Didn't Obama have to compromise to the point that the ACA is/was but a shadow of what could have been?
Ted (Portland)
This pretty well sums it up, we now know definitively that The Dems are really DINOS, have been for decades, as far as the ACA any idiot could tell it was a gift to big healthcare, big drug companies and big insurance all of whose stocks went on a decade long tear, straight up, after the passage of the ACA. This latest move was a gift to Trump. Bernie is the only chance the incrementalists will offer up more cold gruel for us as they insure lucrative futures as lobbyists and lawyers for themselves representing Wall Street dominated healthcare: Joe Lieberman is a great example of the phonies in the Democratic Party.
Wilbray Thiffault (Ottawa. Canada)
The problem with health care in the USA: It is the price, stupid.
ssgardens (Marina, Ca)
Stupid!!! Irresponsible!!! What a mess!!! Basic Economics 101, we are heading into severe, dire times. Just hoping the Medicare and Social Security benefits I have paid for (double taxation given my 37 years of self-employment) will still be there for me to enjoy.
Belltower (South Carolina)
I listened to Bernie Sanders this morning, explaining his "Medicare For All" proposal, how it would be paid for and "phased in" over a period of four years. Importantly, there would be no deductibles or copays. He believes that cost controls and efficiencies will go a long way toward paying for the system. The fact is that Medicare is far and away the most popular system in the country. I'm now a Bernie supporter and have been "on" Medicare for 15 years.
David (Oak Lawn)
I saw the indefatigable Bernie Sanders talking about Medicare For All today on MSNBC. I really like being on Medicare. Sanders had the good idea of expanding Medicare to include dental and vision. Some people say they want to keep their private insurance. I say if they want to keep it, let them, although they don't know what they're missing. But work to lower deductibles, co-pays and drug costs.
Lilly (New Hampshire)
Calling them what they are will help: A managerial financial industry based on an extraction of billions in resources at points of maximum pain and stress for the American people.
Mark Kessinger (New York, NY)
@David -- My late father, who died in 2000, a staunch Republican if ever there was one, used to rail against medicare and other "entitlements." He raised against them, that is, until he was retired and actually had Medicare and was relying on it. Then he couldn't say enough positive things about it!
Casual Observer (Los Angeles)
@David Some employer benefit plans have better drug coverage, lower copays, and easier referrals with affordable contributions. Medicare is based upon the actuarial data for retired people, not everyone from pregnancy through old age, and as such will not work as a universal plan. The idea that it can facilitate a quick change to universal care is just malarkey by people whose in ability to comprehend things in terms of numbers is weak.
Keith (Atl)
My company moved to a high deductible health plan as soon as Obama Care was enacted. They used the threat of taxes to increase our out of pocket cost into the thousands of dollars a year. This does cut my companies costs but, not mine. It was a huge pay cut for every employee. Now we all limit our healthcare and prescriptions. In the long run employees will wait longer for care and costs will go up.
Paulie (Earth)
@Keith I would have started looking for a job as soon as they cut your benefits. Why are you still at a job that cut your pay?
Joe G. (Connecticut)
Here's an idea, although it's probably too simplistic. FORGET the whole notion of regulating any of the private healthcare companies. Get out of that fight. Just let them do what they want. Focus on creating and implementing a good public healthcare option (Medicare for all, or whatever else you want to call it) and just do it. Don't let private interests interfere. Sit back and watch the public flock to it. There's no way the private health insurance companies could compete.
Richard (New York)
@Joe G. Would the public option's coverage be priced to reflect the health status of those who signed up?
Concerned Citizen (Anywheresville)
@Joe G.: EXACTLY. You do not have to do one darn thing. The Individual Mandate was cruel and morally wrong. Nobody has to be FORCED to buy into Medicare at 65 -- EVERYONE takes it, because it is a good deal. If there had been a public option....nobody would have taken awful evil Obamacare with HIGH DEDUCTIBLES....they would have taken the affordable, low cost and FAIR public option. The other plans would have died from lack of sign-ups. Which is why the public option was killed -- by Baucus and Lieberman, owned lock stock and barrel by Big Insurance. They didn't want any fair competition.
C Wolfe (Bloomington IN)
@Concerned Citizen The ACA was supposed to have included a public option initially.
Elizabeth (Minnesota)
Ooh this makes me mad. These 'Cadillac' plans are not cadillac at all, they represent decent healthcare coverage, what everyone deserves. We need to get private insurance out of the industry and with Medicare for All everyone would get the healthcare they need, and the whole thing would cost less. High deductible plans are pathetic, pitiful, and not working. We really need to be able to do better. We just need so some lawmakers to work for the people. Thank you, squad.
Bird lover (Texas)
@Elizabeth Right on! Wish I could recommend this multiple times. Yours, Middle-class and healthcare-deprived
Doug (NJ)
@Elizabeth They are truly Cadillac plans provided to the privileged few. Most people would love to have that coverage, very few do.
Steven Sullivan (nyc)
hmm, d'ya think decades of GOP-led decimation of unions has anything to do with that?
ConA (Philly,PA)
People keep saying that costs keep going up, but deductibles keep going up too. High deductibles were supposed to keep premiums low, but this is not happening. However, high deductibles deter people from seeking care. So now people use the system less and less and pay more for insurance. Show us the numbers because something is not adding up as to why health care costs are going up. The people in this country are already paying more for than our share of the costs!
SR (Bronx, NY)
That's why you never trust corporations to lower prices. They didn't when we gave the ISPs tax breaks, they didn't when we cut factory regulations, they didn't when we let them pay waiters and rigged "gig" economy workers junk wages. THEY. NEVER. DO. Better to cut them out of the process, and let Medicare for All finally make the US a developed country.
Tullymd (Bloomington Vt)
Costs going up? Rapacious greed. Medicare controls costs. No deductibles for me.
ConA (Philly,PA)
@SR Yes! I agree!
James W. Russell (Portland, Oregon)
The goal should be to get everyone up to full health insurance, not punish or take it away from those who have it.
Len Charlap (Princeton NJ)
@James W. Russell - The goal should be an efficient system where everyone's needs are met and cost are not thru the roof. You cannot do that if a significant percentage have private insurance which not only is wasteful in terms of overhead and compliance costs, but which keeps medical data secret so that we cannot have an entity that gathers it, analyzes it and makes medical recommendations based on science, not profit.
Erica Smythe (Minnesota)
@James W. Russell I agree, but the product you're buying needs to be affordable. This was obama's mistake. Hubris..if you will. He thought he could tell you your skinnier plan was junk and that you'd love your brand new Escalade style plan..and would gladly pay an arm and a leg for something you only needed in an emergency. Well..I need a parachute too in an emergency but that doesn't mean I have one under my desk. Allow insurance companies to write skinnier plans..then the states can follow suit and require residents of each state to prove they have health insurance..or they're on their own. No proof of continuous coverage? Then no preexisting conditions are covered for you! Pretty simple..but you can't force people to buy a $20,000 a year product with $12,000 a year deductibles. That's unAmerican.
Auntie Mame (NYC)
@Erica Smythe What's American is that there is always a middle man? (a lawyer taking his cut?) In other places it's referred to as organized crime.. Possibly legal but morally corrupt and a way of punishing the little guy. BTW what is wrong with a healthcare system that covers everyone and is administered by one entity? We have monopolies in everything else now-- e.g. Amazon.
Socrates (Downtown Verona. NJ)
Health spender per person per year by country United States $ 10 586.08 Switzerland $ 7 316.60 Norway $ 6 186.92 Germany $ 5 986.43 Sweden $ 5 447.11 Austria $ 5 395.11 Denmark $ 5 298.82 Netherlands $ 5 288.44 Luxembourg $ 5 070.17 Australia $ 5 005.32 Canada $ 4 974.33 France $ 4 964.71 Belgium $ 4 943.54 Ireland $ 4 869.36 Japan $ 4 766.07 Iceland $ 4 349.09 Finland $ 4 235.55 United Kingdom $ 4 069.57 OECD - Average $ 3 992.35 Every other country has cheaper, more efficient, universal healthcare and generally better healthcare than the backward States of America. Our healthcare system is a giant, corrupt, corporate rip-off. We'll take what Europe, Canada and Japan are having. No research is necessary, Congress.
Lilly (New Hampshire)
None of my European friends can even conceptualize, (yet*), allowing a financial industry to exist which is brutally based on extracting resources at points of maximum vulnerability in our lives. *yet, because my conservative friends in England are being brainwashed into thinking their NHK will benefit from Richard Branson inserting a managerial layer similar to our own, without truly understanding the concept as it works here. That they will no longer not think twice about having, a common example, elderly parents spend a month or two getting lifesaving care in hospital, because they can’t imagine being told they can’t afford getting the care they need. It simply doesn’t compute that they would have risked bankruptcy, losing their house or possibly just lost their parents in this country... which is unconscionably brutal way to expect any population to live... for the sake of a financial industry allowed to profit from increasing our collective suffering.
Lilly (New Hampshire)
By the way, when I lived in Japan, my healthcare was excellent and almost free. I think over four and a half years I paid a total of $10 out of pocket, and very little in taxes. My best friend had a carefree delivery of her first son in Tokyo and spent a week being pampered before they let her go home. Total cost: $150 I pay $13,000/year minimum to the financial industry that calls itself healthcare, without any actual care at all, and this is with the ACA, and no dental or vision care, which adds considerably to my yearly bill. I think it’s time we stopped paying bankers to tell us they won’t cover it, instead of doctors and nurses for actual healthcare.
sam finn (california)
@Socrates None of those other countries suffer from the costly burdens of "defensive medicine" resulting from an out-of-control medical malpractice system foisted on the USA by American lawyers. If the USA truly wants to bring its health care system in line with other advance countries, it must outlaw the medical malpractice system and put medical quality control entirely in the hands of government boards populated by health professionals -- with assistance from accountants and actuaries -- not lawyers, juries and judges
Steven Most (Monterey, CA)
The healthcare elephant in the room is cost, not coming up with imaginative ways to pay for healthcare. Hospitals, imaging centers, device makers, big pharma, and yes doctors are all getting rich on the backs of the public. Until these elements of the "system" are brought under control we will continue to overpay for the same treatment citizens of the developed world get for far less. As long as the GOP controls the government there will only be a continual escalation of costs.
Little Pink Houses (Ain’t That America)
This is another one of the long list of reasons why I continue to lose faith in Democrats in Congress. Rather than propose an alternative, they all vote in sync (except for Jim Cooper TN-5, Ron Kind WI-3 and Scott Peters CA-52) to further deconstruct their greatest success during the Obama years. Rather than take on the corporate interests that were simply reducing coverage to avoid the tax, they folded their cards and went home. Even AOC and the squad. My disappointment seems to be never ending.
Andrea G (New York, NY)
The fundamental flaw with Obamacare was its solution to making healthcare more affordable was splitting the bill among more people instead of lowering the bill. Instead of looking for new taxes, loopholes, and subsidies to make it easier for patients to pay astronomical medical bills we should be focused on cost controls.
Sook (OKC)
What's going on? Why can't the dems propose workable plans? The "progressives" are ridiculous, and I barely hear from anyone else. The media can focus on others. Hopefully they're out there. We need some strong dem leadership, the kind that is experienced, intelligent, and moderately moderate!
Dan M (Massachusetts)
Eliminate unnecessary medical care and the debate about cost will end. "Most physicians in the United States believe that overtreatment is harmful, wasteful and common." "Researchers surveyed 2,106 physicians in various specialties regarding their beliefs about unnecessary medical care. On average, the doctors believed that 20.6 percent of all medical care was unnecessary, including 22 percent of prescriptions, 24.9 percent of tests and 11.1 percent of procedures. The study is in PLOS One."
Maryland Chris (Maryland)
As I read this, two old political aphorisms came to mind: Don't tax me, don't tax thee, tax that guy behind the tree. People vote for Democrats to get stuff, then they vote for Republicans so they won't have to pay for the stuff.
Thomas Adamson (San Diego)
...and Republicans pass tax laws that rob the government of the revenue needed to run things properly. Deficits rise during Republican administrations and fall when Democrats take over.
JSH (Carmel IN)
The 40% tax was to be applied to benefits in excess of the floors mentioned here ( $10,200 for an individual in 2022), not 40% of the total amount. I wonder if many in the House understood this, or really cared if they did understand. Recall that the Medicare Comprehensive Coverage Act of 1988 was repealed within 18 months because the AARP mislead medicare beneficiaries making them believe they would all pay an $800 additional tax to support increased coverage under the Act. In reality, less than 10% were subject to the maximum.
marcus newberry (greenville)
It is not a budget issue only. More medical care does not yield better health. Medical care is not health care and as long as Americans think it is there will be no improvement in health and more medical care at increasingly higher costs.
There is an old political aphorism that seems appropriate here: everyone wants to go to heaven but no-one wants to die. Bottom line: Unless someone supports higher taxes we are headed for a train wreck of epic proportions.
TBone (New Hampshire)
Cadillac tax indirectly mandates high deductible plans. High deductible plans have been shown to lower costs by lowering utilization, for better or worse. High deductible plans (all ACA plans) are the biggest driver behind bending the health care cost curve. Bad policy to eliminate Cadillac plan tax.
jennifer t. schultz (Buffalo, NY)
GOP said dems didn't even read ACA. well none of GOP has read the Mueller report.
Jack van Dijk (Cary, NC)
@jennifer t. schultz I just started to read the Mueller report, man is it a big book.
Leslie Duval (New Jersey)
What's the fix that Dems propose? The GOP has nothing to offer....
Patrice (Andover,MA)
I just quickly looked through the comments but it doesn’t look like like anyone mentioned the increase to the deficit this entails.
ag (chicago)
This article failed to note the massive tax subsidy already in place for employer provided health insurance. This tax subsidy unfairly discriminates against those who have to buy their own coverage. For example, take the case of a self employed plumber who makes $100,000 per year and pays $15,000 in health insurance premiums. Compare that to the plumber who works for an employer who pays him $85,000 per year but also pays $15,000 of health insurance premiums on his behalf. Shouldn't they pay the same amount of tax? They don't. They both have earned $85,000 after considering the cost of healthcare insurance. But the one who is is covered by an employer plan pays less in tax because his adjusted gross income is $85,000 while the self employer plumbers adjusted gross income is $100,000. Outrageous. This tax free treatment of employer provided health insurance is estimated to cost 173 billion dollars in lost tax revenues in 2019 alone. How can the "Cadillac tax" repeal be discussed without noting this outrageously discriminatory tax subsidy?
SL (Santa Fe)
Isn’t the $15,000 tax-deductible in either instance so the plumber’s adjusted year-end income is $85,000 regardless of whether he is self employed or not?
Diane (Boston)
@ag Isn’t the health insurance costs to The self employed person tax deductible? At least in part ?
Duncan (Los Angeles)
It's good to see so many Democrats getting it right: the problem is the cost of care. We pay over $10k per patient, per year in the US while other advanced countries pay much lower costs ranging from $4,070 (UK) to $4,963 (France) to $5,447 (Sweden) per patient, per year (OECD data). They do this while providing cradle-to-grave coverage. No medical bankruptcies, no lifetime of healthcare anxiety. Even Switzerland, which has a system similar in structure to Obamacare pays far less ($7,317 per patient/year) than we do. As your article points out, the"Cadillac Tax" was all about limiting utililization, not about challenging the drivers of our high prices. As a "pay for" it is both clumsy and politically dangerous, and the Democrats are right to get rid of it. We all need decent "plans". I'm not saying we should all have Cadillac health plans, but we should all have Buicks. We can argue about how we get there, and what form our system will take in time, but we must agree that the enemy here is rampant healthcare profiteering. But getting there means taking on Corporate Healthcare. To riff off a popular saying from the Obamacare debate, we will NOT keep big pharma, health insurers and hospital corporations on board. This is going to be a fight.
Ker (Upstate NY)
The headline, Democrats vote to repeal Obamacare, looks terrible. And that will be all that a a lot of people hear. This seems like the worst time to undermine Obamacare, in terms of both the bad headline and the bad financial impact. Sometimes I think the Democrats care more about using healthcare as a tool to win elections than as a tool to help people.
Joel Stegner (Edina, MN)
You have to pay for what you want or scale back your expectations. Our healthcare is the most expensive in the world because we have not controlled costs, which are driven by profiteering and wasting huge sums on futile care at the end of life. Single payer offers far lower costs - and should be promoted that way. It is opposed because it would end the gravy train.
Patrick Stevens (MN)
The A.C.A. was conceived to provide healthcare insurance coverage for every American. It was conceived to have a government option for insurance built in so that insurance companies would have a natural and forceful competition for their pricing. Had that become part of the law this tax would not have been necessary. It was not, and now the tax is being repealed. We have no way to pay for the A.C.A. benefits included in the law. The law is dead. That is a shame. Money won. Insurance stocks should shoot through the sky. Hurray!
Me Too (Georgia, USA)
Oh yes, Americans should really be proud of Congress repealing this Cadilliac Tax that never went into effect and calling it a "bipartisan win that both sides can take home.” I can see these politicians smiling as they go home but not wanting to reminding the American people they just increased the national debt and by repealing the Cadilliac Tax they didn't come up with any means to offset the taxes the government disparately needs. It also shows Americans the Dems have joined the GOP in supporting no regard for fiscal responsibility. Trillions of $ will be added to the national debt by repealing this Cadilliac Tax, but who cares, no one in Congress that is for sure.
La Resistance (Natick MA)
Here’s a source of funding: repeal of the obscene tax cuts recently enacted that disproportionately benefit wealthy corporations—with an exception for those that used that tax cut to hire more people/raise wages for existing workers.
Terry McKenna (Dover, N.J.)
This tax and the idea behind it was always a bad idea. The so called "cadillac plans" are not the problem. The problem is the profit motive in American medicine. In fact, we all need cadillac plans to afford America's high cost medicine.
Hpower (Old Saybrook, CT)
The health care challenge is not coverage it is COST. Repealing the tax enhances the illusion that health care can be free. It isn't. Someone pays, be it the people in your pool or your employer if you are insured or the tax payer if you are in Medicare or Medicaid. When the pain of the real cost hits home in substantially higher taxes and/or premiums (even higher than those who currently have seen big increases) perhaps the message will hit home.
BBB (Australia)
A family member had to go to the ambulatory section of the Emergency Room at a major hospital this past week. Just as our turn was approaching, cases more serious walked in, but all in all, the wait was only 2 hours. The care was excellent, fear was abated, the cost was 3.5 euros. In Australia, there is no charge for urgent medical care, it has a reciprocal agreement with 11 EU countries. We were in Slovenia, on the list. Perhaps Melania, the US First Lady, can Be Best, and step up to the plate and calm the fears of Americans over Single Payer health care. Explain the care that Slovenians in her native country enjoy, and that Americans can only dream about ! All over the EU and in Australia, the Single Payer system coexists with Private Health Insurance. WHY are the DEMs ignoring how this works? Single Payer. The government, pays for the doctor bills for to ANY doctor in the country, finances the ERs, negotiates for and subsidizes drug costs. BUT if you want PRIVATE HEATH INSURANCE, you buy it AND YOU CAN KEEP IT. If you need to be admitted to a hospital, it allows you to choose a Private Hospital, but the key point is this: Your Specialist in the hospital, the one you choose ANYWHERE, works in both the public hospitals and the private hospitals. In the public hospital they are paid by the Single Payer Government and your co-payment. In the Private Hospital, they are paid by the Single Payer Government, your Private Health Insurance Company, and your copayment.
Ana Luisa (Belgium)
@BBB Uh ... Democrats are the only ones who made substantial progress towards their ideal of universal healthcare in decades, AND who successfully protected that progress against relentless GOP attacks on all fronts, AND who are now proposing to take the next step and find a way to move to Medicare for all, and somehow, your question is why "DEMS" ignore how it would work ... ?? My advice to you: start visiting Elizabeth Warren's website, for instance, or even Biden's website. They not only know how this works, they also have the detailed plans ready, AND the passion and competence to make this work. So soon as "we the people" finally give them the legal power to continue to make progress, it will happen. Continuing to criticize them because we did not give them that legal power yet, will only be counterproductive, obviously. The US is a democracy, after all ...
Wurzelsepp (UK)
@BBB, Slovenia is suffering from the same issues all Single-Payer health systems are suffering from, which are lack of doctors, long waiting times and rationed health care, although I admit that not all Single Payer countries are as bad as the UK. Interestingly, the best health care is not provided by Single Payer but by the German 'Bismarck' model, which is in use by France and all the other countries that deliver excellent health care to their citizens:
J.Jones (Long Island NY)
Some middle class people receive subsidies and have lower premiums, but others get no subsidy and have higher premiums under Obamacare. Why should some people effectively give others discretionary income while losing their own? Quite a scheme, isn’t it?
Ana Luisa (Belgium)
@J.Jones The only reason is because the GOP made higher subsidies impossible, back in 2010. Since then, however, Democrats passed bills to increase subsidies for those who still can't afford to buy insurance because they earn "too much". Guess who blocks them, AND wants to take away the current subsidies too? The GOP. As long as people don't understand who does what here, in DC, there will be no more progress.
Alan Day (Vermont)
Great, deepen the federal deficit -- Washington is leaving a huge debt problem for future generations.
Egl (Ojai, Ca)
This just says to me that people are not willing to pay for taxes for health care. It really puts Medicare for all at risk. I noticed that the public unions said in California that they welcome Medicare for All because it will be a big raise in their salaries if they don't have to pay for health care. Who do think will pay for it? Are we really going to be able to get people to pay for the massive taxes it will require if we can't even get this tax? Total federal tax collections were $1.7 trillion in 2017. Medicare for All will cost close to $2 trillion a year. Who is going to pay double their taxes or more? You could double the taxes that the top 10% pays and it won't be nearly enough. People better get ready for a massive tax increase. The groups opposed to this Cadillac plan tell me they think someone else is going to pay for it. Good luck with that.
JW (New York)
@Egl This is exactly the problem. Did anybody that "Recommended" this comment actually check the numbers on which it is based. I did. They are wrong. This may even be a bot post fear mongering over excessively higher costs and taxes if we have medicare for all. That is an out and out lie. It is well known that the costs of our health care system are completely out of control and that a sane, single-payer, medicare for all systems will ultimately cost LESS. At this rate I will die without ever having seen the United States, my country of birth, life and likely death, becoming the democracy I always thought it could be. I so want to live to see medicare for all. Its not everything, but its a good start.
Michael (London UK)
@Egl- it’s a crazy choice - either pay out $10 000 for private insurance in the US or pay $4000 in taxes in the U.K. for arguably a better system. Yet the right has succeeded in making taxes some kind of third rail for politicians. There needs to be a fight back.
Old Old Tom (Incline Village, NV)
Product Capitalism. My goal is to create a product & make as much money as I can. Manufacture a product for a year & one can reduce cost of manufacturing meaningfully, the company has learned how to do it. Service Capitalism - almost an oxymoron. I will create a health care insurance company. People pay me money & I pay their medical bills. Wait, my goal is to make a profit, not provide a service. The more money I do not pay in claims, the greater my profit. One more case: CA PG&E. We're a regulated, for profit Co. providing a service. How can we increase profit? Cut back on maintenance. The unions are backing this bill, their argument has merit. A better bill, I suggest would keep the tax & unionized benefits are exempt within a corporation/co., anyone receiving greater insurance benefits within the co. would be taxed if their insurance was greater than the union plan. Which brings me to the insurance gov workers including pols have. We all should be able to access that plan or there is no different plan.
Rachel (Boston)
Not until the Democrats control both houses of Congress and the oval for four years and with wide margins will there be serious health care reform. That, or there must be an organized march in Washington demanding an end to this nightmare. For those with employer provided plans, which are icreasingly the high deductible plans, who think they are getting good coverage, well you are living in la la land. Your employer is dictating your coverage and the insurance company is dictating your care. You have no choice, despite what the Republicans keep trying to sell. All Americans are impacted by this nightmare. We pay for the uninsured and underinsured who end up in the emergency rooms. I don’t care what system we end up with. I just want the weak and feckless politicians to solve this mess.
Pogo (33 N 117 W)
@rachel What happens when Dims lose control of both the House and the Senate? Paying for someone else's healthcare is not a right held by others over me nor my privilege. Healthcare costs like most services in the world should be paid by the user not abused by the user.
Ana Luisa (Belgium)
@Pogo Then why is it that all Western countries (1) have a healthier population, and (2) have some form of single payer? Here's why: everybody sooner or later gets sick, and no one knows whether you'll be lucky and get better fast, or whether you'll develop a severe/chronic illness. Civilized countries categorically refuse to turn to health of their citizens into a mere lotery. So they create a collective, non for profit insurance fund, where we all pay into to the extent that our salaries allow us to, and which then covers the medical costs of all people once they get sick. I never saw ANY good argument against such a system. Obviously, that you prefer to pay more for your insurance only to make sure that your neighbor, who earns less, doesn't have any, doesn't sound as such a great moral example to follow, does it ... ?
JW (New York)
@Pogo Sorry, what in the world are you trying to say. Other than leveling a Trumpian insult do you not understand how taxes work and what organized, civilized society is. I would suggest to all those that think they should only pay for themselves to start by paying for an education. It might help or it might not but it would be a start.
Hari (Yucaipa, CA)
Couple of things needs to get done. Health care is expensive because of so many variables, one of them being liability and the need for tort-reform; physicians and other medical providers are afraid they will get sued if they do not perfect their treatment options to a T. Most or a significant amount of legislatures come from legal field so they will not touch tort reform. For a simple procedure, even if your doctor knows what ails you, will prescribe multiple tests and the patient goes for 2nd, 3rd opinion and some even fourth opinion to rule out all options, without realizing this is exponential growth in cost of delivering medicine. The doctor does this to avoid any hassle of future court issues. The insurance companies take the money knowing that the actual cost of delivery of that treatment is the sum total of deductables, rest is skimmed profit.
jennifer t. schultz (Buffalo, NY)
@Hari tort reform would be good if the medical devices would FIRST BE TESTED ON HUMANS. no medical devices are tested on anyone. the total hips and knees put out by Johnson and Johnson that were metal on metal were made with cobalt which is a heavy metal. hundreds of thousands of people had to have their total joint replacements redone. those pts didn't even know what was wrong with them. I was hit by a care 24 yrs ago as a pedestrian. no, was not looking at a phone. hit by a drunk driver at 12 noon. two of my plates broke in my tibia. I ended up with 34 surgeries. I also am a RN/BSN in the operating room. I also had to have a spinal fusion. I worked ten more yrs then had to apply for SSD. I was at the height of my nursing career. I also had a head injury. I was making the top level of salary that I could get. the man had no insurance. I didn't need multiple tests. I didn't expect to have two plates break. my dad who worked in the steel industry all his life . He told me that they didn't cool the steel properly. Many people who have an HMO have to get a second opinion. I certainly wasn't getting some cosmetic surgery. I trusted that my plate would endure regular working hours. I had scrubbed a lot of cases where pts were 300 lbs and their plate didn't break.. so many times there is negligence and that has also happened with many drugs such as fen -fen and vioxx or opioids.
sthomas1957 (Salt Lake City, UT)
If the approach to retirement insurance (SSI) had been the same as with health care, Social Security would never have been enacted in the 1930s. Instead, only half the country would have any retirement at all, with your stocks, bonds, mutual funds, IRAs, and 401ks the only thing you'd have to rely on. Plus, those lucky enough to have an employer offering a defined-benefit plan. Thank God today's Democratic leadership wasn't around when Roosevelt was coming up with Social Security.
Lilly (New Hampshire)
That’s why I’m voting for Bernie. He’s the only one focused on finishing the work of FDR.
Ana Luisa (Belgium)
@sthomas1957 Uh ... you mean Pelosi, the only Speaker of the House in DECADES to have managed to get HCR through Congress, including a bill with a public option, and that is now saving an additional half a million American lives a decade ... ? Thanks to Obamacare, it's not "half the country" that has healthcare, but 90%. Ryancare, the GOP's only alternative, would massively lower that percentage. And yet you complain because all of our problems aren's solved overnight yet? Do you actually support DEMOCRATIC change? Because if you do, you cannot possibly blame "today's Democratic leadership" for the fact that "we the people" in so many blue states sent moderate Democrats to DC. Getting moderate Democrats to represent those states HELPS us achieve progress. Of course, if all states would only vote for progressives, progress would happen even faster. But as long as Fox News exists, that will NOT happen, unless you and I finally stop standing at the sidelines yelling "not enough!" at those standing in the mud and who just managed to achieve one more step into the direction of the finish line. ONLY when we start engaging in real, respectful debates with those citizens who disagree will change happen faster. Because that's how a democracy is supposed to work in the first place, remember?
jennifer t. schultz (Buffalo, NY)
@sthomas1957 well don't get hit by a car. I had to use all my retirement while I was waiting for my SSD hearing. I was offered a job auditing pts charts but starting at 9 dollars an hour. at that point I was making top of my salary 25 dollars an hour. what happens to people like us.
theirllbelight (CO)
American worker's consensus seems to be that a $40k salary with $30k health benefits is preferable over a $60k salary with $10k benefits. Go figure.
Carl Yaffe (Rockville, Maryland)
@theirllbelight With this repeal, the health benefits remain untaxed.
PL (ny)
@theirllbelight -- currently, they're getting a $40k salary with $10k benefits. The absurd assertion that employers would miraculously make up the difference and increase salaries to pay for the higher taxes on cadillac plans, or the increased costs to employees for paying higher premiums and copays on the inferior plans, out of the goodness of their hearts, never materialized. It was a fantasy put over on us by Obama and his health economists, like "you can keep your own doctor."
David (NYC)
Quick question: Did AOC and the "squad" vote for this leglislation ? Lowering taxes for the gold-plated health plans ? And also did any of the Presidential Contenders weigh in on this legislation ?
Walter Ingram (Western MD)
The Texas case is predicated on the notion that a tax of zero dollars in not a tax and therefore the ACA is not constitutional. How many more taxes will the Dems do away with? Will it be enough that the ACA is indeed unconstitutional?
Ana Luisa (Belgium)
@Walter Ingram The bill contains more than 1,000 pages. At least one third of those pages contain taxes. So good luck to you if you want to argue that eliminating some of them (= increasing the deficit a little bit, all while saving an additional half a million American lives a decade) would somehow go against the intention of the Founding Fathers ... ;-) By the way, IF increasing the deficit should from now on be considered "unconstitutional", the GOP's only "achievement" under Trump, their massive tax cuts bill for the wealthiest, will be struck down as unconstitutional too, of course ...
jennifer t. schultz (Buffalo, NY)
@Walter Ingram doesn't matter since they gave the tax break to all of his rich friends. then the fiasco of his five million dollar insult wasn't paid for by a fourth of july fairy.
Sendan (Manhattan side)
What? no response from Pelosi. No claim from the NY Times that this vote in her house is a total loss to her. No talk about her claim to fame of getting the the so-called Obamacare law pass. Accordingly this passage was her biggest victory of her long career. But now it’s admitted the this great law is being dissolved by almost all Democrats including the conservative/centrist Democrats. Yet no word of explanation from the honorable speaker, Mrs. Pelosi. The Times quietly stated “In seeking to get rid of the tax, the Democrats appear in one sense to be joining the slow dismantlement — or at least undermining their own argument that the embattled health law will save taxpayers more than it costs them over the long run while holding down health spending broadly”. For Pelosi this vote has got to hurt.
PL (ny)
Best news all year! The idea of restricting decent health care for people undermined the entire claim that the "Affordable" Care Act was about expanding healthcare. It diminished healthcare for all of us. Good for the Democrats for finally recognizing the fatal flaw in Obama's "signature legacy." The quality employer-provided health plans, the so-called Cadillac plans -- were the kind of coverage all Americans should get. Health care is a human right -- NOT "bending the cost curve downward" and putting those costs on the backs of patients. All that did was deny health care to more people, as they self-rationed what they could no longer afford.
sthomas1957 (Salt Lake City, UT)
@PL. Yet one more example of Democrats trying to be more like Republicans so the Republicans will like them more.
jennifer t. schultz (Buffalo, NY)
@PL it is too bad that GOP has no solution at all. also, if it is struck down around 40 million people will have no insurance.
Paul (California)
Everyone wants a free lunch. " Don't tax me, tax the fellow behind the tree" Politiicians bow to their masters, not the voters. Everything is good until the music stops. Just ask the Greeks. They were fortunate to have a short term bailout. There were many failures of the ACA. One was the failure to deal with fee for services medicine. Another was Big Pharma. Everyone seems to want more health care, but no one wants to pay. Dems want to go crazy over social issues. They can't get a grip on financial issues or ecology issues. They expect printing money or taxing the mega rich will work. Perhaps for a short while. Then the bottom falls out. Just like Dems supported NAFTA (Jobs disappeared, BiG Auto collapsed about 2010, and the results were many workers were hosed. The Dems didn't notice. High on the media news about social issue. Like someone on coke, they just are too high. And short term focused. All they want is another time in the seat of power. Just do the opposite of Trump. Spend money. Open Borders, A social epiphany. BUT, Nature doesn't care. There is no free lunch. Rushing to the apocalypse makes everyone giddy. BOL
jennifer t. schultz (Buffalo, NY)
@Paul George H. W. bush came up with NAFTA. didn't get it passed then because of the saving and loan scandal. newt wanted NAFTA passed. So GOP came up with it first. And fee for service has been around forever. . for those who can afford it. concierge medicine. As far as big pharma George w. bush set up medicare part D it was put in that there would be no negotiating for scripts. and ecology issues is rather large. china is sending the u.s. at least two tons of trash back to the u.s. and the perks that big pharma reps get such as lavish trips, catered lunches etc. I have seen it working in the operating room for 18 yrs.
Gary Valan (Oakland, CA)
Employers get over $400 Billion a year tax relief that is borne by all of us and this Cadillac tax relief is probably added on to it. Why? How is it that I can't get a "Cadillac tax" as a self employed person?
David (NYC)
Many of the Commentators here blame the Health Insurers for the high costs of Health in America. But in my experience, its Hospitals that charge excessively. A 12 hour trip to the Emergency Room can cost $3000 in NYC ! If you have heart pain they will keep you in the ER for as long as possible (charging hourly rates to the moon) and then for any procedure charging thousands of $$ for the Operating room and staff. I just have no idea where all the money the Hospitals take in, goes to ! And even if Medicaid and Medicare pay low rates (and technically are subsidized by the Health Insurers which makes no sense) the Hospitals should still run a large profit, but i guess since most Hospitals are non-profits, they must be running the hospital finances like a bunch of fools ! Doctors also charge high fees but if you think about it, after 6 years in College and then 2 years as a resident and then many years before actually practicing in a private (money-making) setting - the doctor has to make up for alot of lost time !
jennifer t. schultz (Buffalo, NY)
@David I worked in surgery for 18 yrs Operating room nurses have to have even more technical skills than they used to. When Bill Frist was head of the senate he had left humana health care as its CEO. Humana was the first for profit hospital. Kaiser I also believe is for profit. Most hospitals are now large corporations. The average age of nurses is now 50 to 55. Most of the nursing teachers are even older. Many nurses have left hospital nursing to become agency nurses or traveling nurses. they pay forty to fifty dollars an hour. . Plus agency nurses don't take any on call duties. When I was working in 2002 I had to take 24 hr call on the weekend for 1.25 an hr. Where can someone find a babysitter for a dollar and twenty five cents an hr. or fill their gas tank for that much. So I didn't make thousands of dollars an hr. I worked in the Midwest and we had no union. ALSo, many medical schools are now come in with a bachelors degree and two yrs I have seen some surgeons that didn't know how to do CPR or take a blood pressure. . and nurses just don't hold a pts hand when they are going to sleep. We have to be responsible for how a pt is positioned and have to count our instruments and needles.
Paulie (Earth)
Doesn’t anyone see what this is about? It’s getting union votes for the Dems. It’s giving republicans one less thing to run on.
George Orwell (USA)
Taxing people's health care. Crazy liberals. They couldn't run a pop stand.
Dale (New York, NY)
The repeal of this tax is a sign that we need an overhaul of the healthcare system that is not just a half-measure. While ACA did a lot to push us in the right direction, politicians need enact measures for our future that may be unpopular in the short term. We need to put the average American first, and ensure everyone has access to healthcare. If this means a tax to replace my soaring premiums and deductibles, then so be it.
This country is not capable of doing health care - you get sick - show up in the emergency room for treatment - don't pay - bankrupt all the hospitals - then no one has health care.
Concise and true.
richard (Guil)
It's an absurd truth that health care has become a positive issue for the Republicans. No matter what the Dems suggest the fact remains that most people get at least part of their health coverage from their place of employ. They basically see this as the free part. When they are told that taxes will rise under medicare for all or universal healthcare they look like a deer in the headlights and back away from support of any sensible public health plan. And they should. Until the insensitive elitists in the Democratic party see that they have to explain that health care will cost an average citizen less than they pay out of pocket now it is a dead issue. Why can't they see that they have to somehow shift health costs to employers or the very rich in order to make the middle and lower classes support any rational health care system. Corporations have been left off the hook in the recent tax bill and maybe it is time for them to start paying a real share of health care costs for their workers. They could do this, for example by placing the funds they now use to pay for private insurance into the medicare or universal health fund. Whatever they do the Dems better get this straight fast if they want to make us believers.
citizen (NC)
By having to eliminate the tax, is it a way to say improvements can still be made to the ACA (Or Obamacare), and preserve ACA. What happens if the Supreme Court were to declare the ACA unconstitutional?
Joe (New York)
This tax was a shameful way of shifting cost for the ACA onto the middle class. Democrats were right to finally start listening to their voters. The ACA was a corrupt step in the wrong direction in the pursuit of a noble goal. The next step is the necessary one: Medicare for All. Health care must be seen as a right. You can't protect the profit margin of private companies while also pretending to prioritize the health of your citizens.
George Orwell (USA)
@Joe Socialism doesn't work. It never has. It never will. If you and your liberal buddies want to form your own plan...fine. BUT DON"T FORCE EVERYONE INTO IT.
Bob Richards (CA)
@Joe Health care is already a right in most respects - just like the the right to practice a religion, the right to free speech, the right to keep and bear arms, the right to eat. However, the government doesn't maintain your local church building, provide megaphones to all who ask, provide a firearm to all who ask, or provide food to all who ask. You are relatively free to get whatever health care you like. It is true that the government does interfere in your choices more than they should - for example, by banning the use of certain drugs - but you health care choices would be even more constrained by Sanders' MFA proposal (or the House version of MFA).
Considering (Santa Barbara)
@George Orwell You know that the military, police, educational and judicial systems, as well as the interstate, waterways and air are all socialized, right?
Dave S (Albuquerque)
The Dem's are pushing this through so the R's will re-affirm the ACA is still the law even when this tax was eliminated. It'll be very hard to argue the zero'ed out penalty, errrr, "tax" nullifies the ACA when that bit of chicanery gets argued before the SC. (You don't think Roberts called the penalty a "tax" without some RW think tank consulting him about the possibility of killing the ACA after eliminating the penalty, errrr, tax. The R's were playing 3-D chess, and this is the D's response. Clever, though expensive...)
Lane (Riverbank ca)
Obamacare was sold under false pretenses. Millions of middle to lower class working folks were saddled with premiums approaching mortgage payment levels as result... Obamacare was only a vehicle to greater political ends. The best healthcare reforms would to have minimal government,insurance administrative bureaucracy standing between Dr and patient when patient is treated and pays for services rendered. Obamacare over reached with too many politically charged mandates far beyond a simple plan covering basic catastrophic injury,disease or illness for all.
jennifer t. schultz (Buffalo, NY)
@Lane I pay rent not a mortgage but it is close to that. and premiums for health care was already close to a mortgage before ACA even passed. and the simple plan GOPwanted would discriminate and charge females more. they charged them more before ACA.
Steve (Los Angeles)
Democrats doing Trump's bidding. Having a small tax on health plans costing more than 11,200 for individuals and 30,100 for family coverage is not unreasonable. My guess is that right now, an individual, age 64, can get great group coverage for $7000 a year, max. Add in a spouse, that is another $7000 for a total of $14,000. I don't know of too many 64 year olds with children, but lets say they have 2 lazy 25 year olds living at home, their coverage can't be more that $5000 a year, remember they are 25 years old when healthcare costs are much less than 60 year olds. So, that is another $10,000 bringing their 4 person coverage to $24,000. A lot less than the $30,100. Essentially this another tax cut for the rich. Congratulations. Why are Democrats so sleazy?
Bob Richards (CA)
@Steve I don't know where you live, but where I live, the median price on the state's insurance exchange for "great" coverage (not really that great, a Silver HMO so limited selection of providers and $7,550/yr max out of pocket) is about $1300/month or $15,600/year. I don't know why you would think a group plan would be that much cheaper - esp. if the group comprised mostly people over 60.
Steve (Los Angeles)
@Bob Richards - I'm 68 now. 4 years ago I was working for a company paying about $550 a month for Kaiser on a GROUP plan which pretty much covered everything with minimal deductibles, like $15.00 (fifteen dollars). After I was off the plan, that same insurance was $900. So, I went with the BRONZE plan which cost about $550 a month, and you are right, had huge deductibles. So, yes, you and I are in agreement. I can only tell you how much I paid under a group plan and then the next day, without the group plan my insurance rate doubled. Of course, under Obamacare, you could go 5 years paying, like you said, $15,000 a year, but then if you got cancer you'd still be able to buy the same coverage which you couldn't get under the old, "you've got a pre-existing condition so we can't cover you." programs. And if you are a homeowner with a family and a retirement account you couldn't take the chance of going without insurance.
Laurence Hauben (California)
If Bernie, Warren, and others advocating Medicare for All want to succeed in passing this huge change to our broken system, they will have to sell it not only to the American people, but to American employers. Show employers the savings single payer would bring them, and then maybe you have a chance to succeed. Otherwise, it will never pass, and the fear-mongering by Trump will get him reelected.
Seamus Conn (Kingston, Canada)
Just do yourselves a favour and copy Canada's Health Act word for word. You'll get used to not having to worry about facing catastrophy for yourself and your family. And, not having to bear the shame of letting people who aren't as special as you, and their children, go without.
Hal Paris (Boulder, colorado)
I thought i was on top of the news. I must admit i'm totally fuddled by most everything going on in Republican America. I am dropping out of following anything and will simply vote for only any democrat who wins the nomination. It is just too much.
Mkm (NYC)
@Hal Paris - it was the Democrats that introduced and passed this bill today. Blaming Republicans may fit the narrative but it's not reflected on the votes.
Karen (LA)
So burned out... E v e r y D a y more madness. Watching Trump’s rallies... I can close my eyes, see and hear Nazi rallies. The escalation of hate is unbearable.
Lilly (New Hampshire)
Now is the time to engage before it gets even worse.
Rick (Wisconsin)
The Dems did not do this for unions-that’s laughable. They did it for their corporate masters.
Steve Davies (Tampa, Fl.)
Obamacare was a sellout to Big Pharma and the health insurance industries, which have bribed both major political parties. Medicare for All works in many countries and could work here. Don't blame Obamacare or the government for the greed shown by health insurance companies. I don't know anyone who hasn't been treated badly by their health insurance company. The profit motive is what it's all about. Those companies always try to find a way not to pay for the care you need.
jennifer t. schultz (Buffalo, NY)
@Steve Davies sorry George w. bush was the sellout on big pharma medicare could not negotiate price of drugs. plus trump said all these pharma companies were supposed to move back to the u.s. plus, three blood pressure medications made overseas ended up having carcinogens in them.
Dr. John (Seattle)
The Democrats are in total disarray. Trump has made them do some truly crazy things.
Charlie (NJ)
The richest benefit plans in America are predominately public sector employer plans and union plans. These are democratic voters.
jennifer t. schultz (Buffalo, NY)
@Charlie actually the richest plans are fee for service or concierge plans.
itsmildeyes (philadelphia)
So, here’s what I know, fwiw. For years beginning in the late 70’s or early 80’s, my husband carried medical insurance for our family through his employment as a lineman for a utility company. He paid part of the premium and his employer paid part. It’s so long ago, I think he was covered in full and he paid additionally for me and our children. This was part of of a negotiated compensation package between the utility and the labor union. Over the years, the deductible amount rose, coverage decreased, out of pocket expenses increased, premiums increased. We usually never met the family deductible; so like many commenters here, it often ‘seemed’ like we were paying for nothing. (Until my husband got cancer and died. $$$.) This was long before the ACA. Every time a new contract was negotiated, medical insurance was a point of contention. Even back then there was an attempt to tax the medical benefit as income. The unions fought it because members were already getting less coverage for higher premiums and it was a benefit, not actual wages. Tying medical insurance to employment provides the employer with a stable compliant workforce. It’s very difficult to move jobs when your healthcare is tied to your employment. The position of the union was, pay us what our work is worth in actual wages and we will purchase healthcare independent of the company or continue the benefit untaxed, which was to the benefit of the company. All long before the Affordable Care Act.
jennifer t. schultz (Buffalo, NY)
@itsmildeyes thank you GOP still wants to tax health care as income. they want to tax it before they take your money out . Pretax. way before the ACA
alecs (nj)
What advocates of Medicare for All don't understand (or ignore) is that millions of Americans get free income in the form of health insurance subsidies from their employers. Most of them will fight tooth and nail for this privilege . If all employer provided health insurance was taxed, this money probably could cover most of those who have no insurance at all. But my hunch is that this would never happen - and this article explains why...
itsmildeyes (philadelphia)
Alecs, Please see my comment above. Also, if I might gently suggest, I think a re-emergence of a global labor union movement is the only hope we have any more. Citizens (so-called) United and the consolation of wealth among a staggeringly small few is a far greater impediment to affordable medical insurance and a decent standard of living than anything conservatives can convince you of the ‘unfairness’ of labor union wages and benefits.
jennifer t. schultz (Buffalo, NY)
@itsmildeyes justice stevens who just died dissented against citizens united. . worst thing ever . corporation a person.
James Ribe (Malibu)
"Pay for itself." What a joke. President Johnson told us Medicare would "pay for itself." It now costs $740 billion per year -- more than the defense budget.
Doctor Woo (Orange, NJ)
@James Ribe*** it is no where near the defense budget
James Ribe (Malibu)
@Doctor Woo This year's Defense Authorization Act (just passed): $733 billion.
1blueheron (Wisconsin)
Repeal the largest tax break in history. Let the people live! Elect leadership that will address the medical and insurance monopolies of the corporate owned nation state and its' unlimited money in politics.
Deb Pascoe (Marquette, MI)
How about repealing Trump's obscene tax cuts for his rich cronies instead? How about making corporations like Amazon actually PAY taxes?
Matt (TX)
@Deb Pascoe Problem is that corporations like Amazon can go somewhere else. That’s how taxes end up getting negotiated. It’s not as simple as you suggest. Also, I truly don’t understand how trumps tax bill was for the wealthy. Other than his increasing the inheritance tax level. So in that sense it benefits wealthy people, a little. But not really because the former law was pretty unfair. Someone who leaves 3 million to their family was taxed at a high rate just like someone leaving 15 million or more. So they increased the threshold to 12 million. Someone leaving a few millions dollars now doesn’t get caught up in the inheritance tax. Guess who benefits from that? People like President Obama, and the Clinton’s. Plenty of members of Congress. They are millionaires now, but not super rich. My family isn’t wealthy at all. We benefitted from the new tax changes.
Mephistopheles (Austin, Texas)
Regardless of the lies the radical squad of the Democratic Party wants us to believe, Health care is a business like any other that obeys the rules of capitalist markets. And It is not surprise the democrats did away with this part of the ACA. From the start, the ACA was doomed to failure. Only when the bills started coming in they realized it was an unsustainable illusion even under a potential Hillary Clinton administration. Obama sought and got advise from really incompetent "experts" who placed political demagoguery goals ahead of the real public health needs of Americans. Most alarming is that the same "experts" have now found an audience with those neophyte political demagogues who lack expertise in planning, delivering, and funding public health programs, but are loud enough to propose unrealistic, and unaffordable schemes that most Americans find incomprehensible. In the meantime, as the democrats engage in ridiculous distractions, Trump's minions are busy at work to come up with a plan that would be much better than what the democrats can offer before 2020.
Matt (TX)
@Mephistopheles This. And one of the core ideas in the senate report that Obamacare was based on was the notion that if people were forced to pay more medical expenses out of pocket, then this would create backlash which would force price shopping and reduced costs. Of course that’s not what happened at all. What happened is that people just spend more on health expenses and/or don’t go to the doctor despite having insurance. It’s a no win situation.
itsmildeyes (philadelphia)
Meph... Donald Trump said he had a replacement for the ACA during the campaign before 2016. After he was elected, he said it was just about ready to roll out. Just fixing a paragraph or something. It was going to be more and better, bigger faster. Everybody covered. Cheaper. Awesomeness for everyone. They had the House and the Senate. Then what?
Woof (NY)
The Obamacare Tax (correct name excise tax) was once seen as a good idea by economists From the NY Times, 2010 The health insurance excise tax JANUARY 9, 2010 "OK, clearly I have to weigh in on this. Should there be a limit to the tax deductibility of employer-provided health insurance, which is what the excise tax in the Senate bill is supposed to fix? My answer is yes, but the final bill should address the criticisms. ..... List of criticisms The last argument is that this hurts unions which have traded off lower wages for better benefits A last general point: we really don’t know what it will take to rein in health costs, but that’s a reason to try every plausible idea that experts have proposed. Limiting tax deductibility is definitely one of those ideas. Bottom line: the details of the excise tax should be fixed, but it’s on balance a good idea." (Paul Krugman, NY Times 1, 9, 2010 The Democrats in the House beg to differ
Len Charlap (Princeton NJ)
As others have said the way to reduce healthcare costs is not by the Cadillac tax, but by instituting a true universal government run system such as Bernie's Medicare for All. But even worse is the idea that we have to have taxes or borrowing to pay for gov programs. The gov doesn't need your money. It can (thru the FED) create as much as it needs out of thin air. Just think about where money you pay your taxes with came from in the first place. Unless you have a printing press in your basement, it originally came from the federal gov. But there's a catch. If the gov needs to create too much money to do the things we want it to do, we may not be able to make enough stuff to soak that money up & will have too much money chasing not enough stuff, i.e. excessive inflation. This is rare & is usually caused by shortages, e,g, of oil. But that's easy to solve & where taxes come in. Taxes allow the gov to take back the excess money & prevent inflation. THE PURPOSE OF tAXES IS TO ADJUST THE AMOUNT OF MONEY IN THE PRIVATE SECTOR, NOT TO RAISE MONEY. The more we can produce, the lower taxes can be. So if we need to tax, it should be done in a way that increases production. Taxes can have beneficial side effects, A tax on carbon helps the climate. A tax on the Rich decreases inequality. The Cadillac tax MAY help decrease health care costs, but there is a far better way to do just that.
Dan (Boston)
@Len Charlap Ah yes, the old hyperinflation strategy. It's always worked so well in the past. Weimar Republic. Brazil in the 80's. Venezuela now. Brilliant thinking!
Len Charlap (Princeton NJ)
@Dan - History shows that hyperinflation is not caused by the excess printing of money, by excess government spending, but by some other factor. Then as prices rise, governments do begin printing money, usually because its citizens are starving, but the economy is constrained, production cannot increase, so this exacerbates the inflation. During and right after WWI over 1,000,000 Germans died from starvation. Germany simply did not have enough arable land to feed its people and the allied sea blockade prevented it buying it elsewhere. Food prices went through the roof. There was clearly no way to increase production. But people were starving. So the Weimar government began to print money. Of course, this raised prices further and we got 1,000,000,000 mark stamps. But it is important to note that inflation caused the printing of money. Then the printing of money caused more inflation. In Venezuela, oil was practically their only product. When the price of oil fell 60%, everything they imported drastically increased in price. In Zimbabwe, the farms were taken from those who knew how to run them and given to those who didn't. Again production fell, and prices rose. In the 1970's we had the oil embargo which not only raised the price of all products made from oil, but more generally of all products that had to be transported. And so on. These are facts, not myths.
Jp (Michigan)
@Len Charlap:"The Cadillac tax MAY help decrease health care costs, but there is a far better way to do just that." That was a statement worthy of Joe Biden. Solidarity to some degree forever! Do you, your family, neighbors or co-worker drive a vehicle assembled in the US by union labor? Here's a list of this year's models:
MJG (Valley Stream)
My wife and I voted for Obamax2 and Hillary. The Affordable Care Act had hurt my family terribly. We are 2 physicians, upper middle class. We work hard and sacrificed for our careers, and to help others. We also have preexisting conditions, including thyroid cancer and diabetes. Our health insurance premiums are much higher since Obamacare was passed. Our drug coverage is terrible, although astronomical co-pays went down slightly under Trump. We will be voting Trump because I know that the next Dem president will make our healthcare worse than ever. Obamacare is horrible, for me, my family and my patients, and all the Dem candidates promise that their "fixing" of healthcare isn't done. We won't be able to survive any more Dem fixes!
ER (Marina del Rey)
@MJG Your logic is flawed. Vote for the guy that wants to repeal the law and basically go back to how things were. How things were were terrible and Trump has no plan, let alone a better one IF he can replace it. Replacing it means Trump has to be competent enough to make a viable law. Why not just fix the costs in Obamacare? Much simpler.
yulia (MO)
And how did Trump make your medical insurance better? I am not fan of Obamacare but before it situation was not much better. People with preexisted conditions could not get any coverage. Premiums and deductibles were growing at crazy rate. One thing was better. People without health insurance were not required to pay fine. I don't want to go back to the old system, I want to move to Medicare for all, and I will vote for who supports the idea.
MJG (Valley Stream)
My health insurance was much, much better before Obamacare. Premiums were lower and copays were a few dollars. Trusting those that made my life miserable with fixing the problem is just plain nuts. What Trump did was he stopped adding, and froze, mandates on health insurance companies and this lowers costs to consumers. Your Trump hatred will never convince me that I should sacrifice the health of my family. There are many, many like me.
Erica Smythe (Minnesota)
As a conservative, I think this tax should go into effect tomorrow. Let the Democrats own this abortion of a law.
farleysmoot (New York)
Most of the so-called "middle class taxpayers" affected by ACA tax were public union employees who got a pass and quick exemption by Obama administration. Looks like the Dems are about to exempt most of their wealthy donors with this bill. If you have an itch and the sheets and blankets appear clean, look under the bed for the bed bugs.
Richard Winchester (Illinois)
This opposition is ridiculous. Either Obamacare is great as most Democrats say or instead, as many Republicans claim, Obamacare needs to be repealed and replaced. How dare these Democrats agree with Republicans?
Ana Luisa (Belgium)
@Richard Winchester It's actually quite easy: unions have shown that the Cadillac tax doesn't really make insurance more affordable, as Democrats want (but the GOP opposes), whereas it does increases taxes on the wealthiest (= what the GOP opposes too). As the GOP only cares about lowering taxes for the wealthiest, for once they can agree with a measure Democrats support for totally different reasons here. In the meanwhile, objectives studies show that Obamacare insures 20 million Americans, thereby saving an additional half a million American lives a decade. And that, indeed, is Democrats' definition of "great".
Charles (New York)
@Richard Winchester "How dare these Democrats agree with Republicans?"... What plan to replace the ACA have the Republicans proposed that you are suggesting the Democrats are in agreement with?
sam finn (california)
Dems are showing their true colors -- slavish support for public employee unions -- the main beneficiaries of "Cadillac" health plans -- tax free bennies for public employees -- and off-the-books in government budgets, -- and out-of-sight to the rest of the public. And, lest Repubs get too self-righteous, their darlings -- police and fire -- get the most generous public employee union bennies -- including tax-free "Cadillac" health plans.
DJOHN (Oregon)
Yes, typical of democrats. We all love Obamacare but want others to pay for it. And recall this was a democrat on democrat law. So, no Cadillac tax, shoot, no tax on health care costs for anyone, other than those obtaining health care for themselves, and who cares about them anyway? Oh, and remember how Obamacare was supposed to bring in young, healthy folks to subsidize older people? Recalling that young folks vote, Obama then eliminated those under 26 years of age from having to get coverage, allowing their parents to pay instead. Just more selfish dems looking for a freebie and finding others to pay, not themselves.
Memnon (USA)
The Democratic Party's "Don Quixote" presidential candidate former Vice President Biden, challenged any and all comers to a battle royale over any attempts to dismantle or replace the Patient Protection Affordable Care Act (aka Obamacare) during the unveiling of his national healthcare plan. Yet I read in the NYT the titular head of the Democratic Party House Speaker Pelosi and her neoliberal centrist House leadership team are taking a wrecking ball to one of the financial pillars of Obamacare; the Cadillac Tax on ultra-premium health insurance plans. Mr. Trump and HIS Party, formerly known as the GOP, previously succeeded in judicially castrating Obamacare by having its funding mechanism deemed illegal. So where is "Don" Biden charging to rescue his political love Obamacare from being attacked by his fellow Democratic neoliberals? How does Speaker Pelosi and Mr. Biden plan to finance Obamacare without key sources of revenue and cost containment on Cadillac healthcare plans which was containing the upward spiraling premiums of ALL healthcare insurance policies?
Ana Luisa (Belgium)
@Memnon The reason why Biden and Pelosi passed Obamacare is because it insures 20 million more Americans, thereby saving an additional half a million American lives a decade. Any patriot who agrees that America can't be "great" if its population isn't healthy, cannot but applaud them for having achieved this, AND having protected it successfully for an entire decade now against GOP attacks. A decade later, the GOP gave the wealthiest Americans a tax cuts that adds $2 trillion to the deficit, and once again ended the Democrats' "pay as you go" rule (= don't pass any bills that add to the deficit). They also deliberately implemented Obamacare in the most incompetent way possible, making millions of people loose their healthcare already. If in such circumstances, objective studies show that the Cadillac tax may soon have an impact that goes directly against the main intention of the law, then of course, the right thing to do is to suspend it, even when it increases the deficit. It's precisely BECAUSE progressives and more moderate Democrats agree on this, that the bill will pass, you see? In the meanwhile, many other aspects of the law, that have proven to slow down healthcare costs, continue to function exactly in the way they were designed to. And the GOP continues to have NO healthcare improving plans at all, quite on the contrary ... As to the individual mandate: Obama never enforced it, and managed to curb cost increases anyhow, so it wasn't crucial to fund it.
Memnon (USA)
@Ana Luisa No one could honestly dispute the PPACA was a significant step toward the goal of restructuring the U.S. healthcare system to provide every resident access to healthcare at a reasonable cost regardless of the payor; individual/private insurance or government. It is also a fact every other comparable nation in terms of populist democracy, economic and technological advancement has, albeit not perfectly, decades ago achieved the goal of near-universal healthcare access at significantly less cost than the U.S. as a percentage of domestic GDP. Yes, millions of U.S. citizens, some for the first time, gained SOME access to healthcare. But an estimated 30 - 40 million U.S. citizens remained uninsured and millions more have health insurance but NO effective access because of unaffordable co-pays and first dollar deductibles? The ideal should not be the barrier to better. But you also don't rely long term on a vehicle with built-in defects as your primary means of transportation. Slowing down "cartel" like healthcare pricing making reasonable access virtually impossible for millions is NOT achievement. And contrary to your comment the individual mandate was enforced under President Obama. One of the endemic fallacies in the healthcare debate is central to the issue of the Cadillac Tax; cost containment is an effective mechanism to combat monopoly pricing of goods and services or exorbitant rent-seeking by healthcare industry services and device providers.
b fagan (chicago)
Dear Democrats. Please protect one of the better things you've done for people in this country, don't weaken the ability to provide access to healthcare for those who have none just to protect a few dollars for people who have the best plans.
Steve (Los Angeles)
@b fagan - A lot of people commenting are claiming that "public employee unions" have Cadillac healthcare plans. I highly doubt that. Group plan insurance carried by, let's say the City of Los Angeles for their employees, probably averages $6000 a year. That is a long way from $11,200 for an individual. But lets say someone's Cadillac Plan was $15,000. Big deal, they'd pay tax on the amount over $11,200 which would be, if they were in the 25% bracket, approximately $1000 in taxes on $4000 in benefits. Big deal. Why should we bend over for someone making that kind of money?
Democrats shooting themselves in the foot? Also the rather buffoonish impeachment squabbles. Oh yeah, and let's not forget open borders with Medicare for border crossers. Good grief, if economy continues to thrive Trump wins in a landslide and the House reverts to Red.
Susan in Maine (Santa Fe)
One health care cost that many people ignore these days is the cost of the expensive art collections many hospitals have. Expensive original paintings, sculptures, etc. I remember when the University Hospital in Seattle added a Debra Butterfield horse sculpture to their collection at a time when they cost around a million dollars! And many doctors have expensive art in their offices because they can write off the cost and have a collection that might increase in value at the same time.
Morris Lee (HI)
This is the effect of having people with absolutely no qualifications making finical decisions that will take decades to correct.The dams are playing into the GOP game. We will run out of room to borrow and then will cut benefits. We should be looking at out disgustingly bloated military budget.I guess fiscal responsibility is a outdated concept.
The plan always needed a public option. The GOP put a poison pill in the plan to make sure it would never work all as a whole. Making the IRS the gateway was a huge mistake. Give everyone a chance to buy into a Medicare type plan while they are working age.
Shamrock (Westfield)
No attempt to even contact Obama. He truly his the invisible man.
HBdano (Huntington Beach, CA)
Now is NOT the time to hitch yourself to a "Medicare for All" plan. Right now Medicare is staring down the barrel of all those Baby Boomers about to enroll for coverage. It's like everyone knows there is a hurricane coming so I bet we can get a good deal on room at the beach.
Mr Peabody (Brooklyn, NY)
Hilarious --- This is the funniest thing the Democrats have done! Now they can never complain about the Republicans killing the ACA (Obamacare) because they did it themselves. Always seen as a way to get revenue from high priced plan recipients now totally shot down by the Democrats. It really should be NO mystery why this happened --- their main constituency -- labor unions --- are recipients of these great plans like auto workers and municipal workers. These folks pay next to nothing for plans that give them free everything, including all out dental. These plans probably cost anywhere from 20K to 25K for a family. PS.. No Federal worker has a plan like the Auto Unions or the NYC Teachers or Sanitation workers where they get free dental / glasses etc. Federal workers pay a third of what the annual premium is (annual premium averages 17K) as opposed to other workers who pay nothing.
RachelK (San Diego CA)
How about the steep fine those of us who cannot afford private insurance through the ACA? I am “sick” of paying for nothing when I would happily pay more in taxes for socialized medicine!
irene (fairbanks)
@RachelK Check out Liberty Health Share. It's a health cost 'sharing coop'. Very affordable (about 1/10 of what Obamacare would cost two adults in their early 60's) and if you are a 'subscriber' then you are not subject to ACA nonpayment fines.
JustInsideBeltway (Capitalandia)
Whenever America tries to reduce health-care costs, it does so by trying to get people to use the health-care system less. Whenever Europe tries to reduce health-care costs, it does so by trying to pay doctors and hospitals less. Totally different approaches.
Jeff (Bay Area, CA)
The democrats continue to casually betray their constituents, just as the republicans do theirs. Perhaps it’s time to end the two party system?
Chris (DC)
@Jeff Unfortunately, that's virtually impossible. The founders may not have intended to create a two party system, but that's precisely what they did. To get rid of the two party system, we'd have to do away with the "first past the post" system. More than likely, that would require a Constitutional amendment.
617to416 (Ontario Via Massachusetts)
@Chris That's right. Though a parliamentary democracy, even with first past post, might support three or four parties. What would really improve our system would be to switch to parliamentary democracy. The advantage of parliamentary democracy is the executive and legislature are united in one body. A unified government is a more accountable government, as the party that controls it is completely in charge—getting all credit for success and all blame for failure. The voters elect it in or out en masse. This forces the government to be responsible and it gives the people an effective check on bad government. Our Founders made the mistake of letting different government bodies check each other—and then weakened the voice of the people by an unrepresentative Senate and the electoral college. In a parliamentary democracy the people's votes matter because the election changes (or keeps) the ruling party in one fell swoop.
Buttons Cornell (Toronto, Canada)
To get rid of the two party system, you have to stop States from assigning all their electoral college seats to one party. If election winners represent the area they actually won, you would end up with Republican representatives seated in the same State house as Democratic representatives. This would also allow smaller parties to have a chance to win a few seats each election. This would also mean republicans having some voice in California and some Democrats having some say in Texas. All it takes is the will to change.This would make for a more diversified Electoral college.
Peter (New York)
The irony of the Cadillac plan is that if one buys a silver plan from the exchange it is about $11,000 which is about the same dollar amount where the tax kicks in. (male, non smoking, age 55) The Democratic sponsorship of the bill also shows how ironic it is that they are also killing Obamacare (removing a source of funding)
Observer (Washington, D.C.)
This is what moderate Democrats do. This is why we need progressive Democrats in office - not just "compassionate conservatives" with the Democrat label.
Kathleen Adams (Santa Fe, NM)
The progressives voted right along with the moderates in this. No help there!
I am a Democrat who fully supports the ACA. And I hate the so-called Cadillac tax, and am relieved it is going away. Here’s why: I have a chronic illness. In order to have any quality of life, and reasonably hold down a job. I need access to medications that happen to be very expensive. And only a so-called Cadillac plan will cover them without me going bankrupt. Nothing else works. Everything else had been exhaustively tried. Including any so-call “natural” remedy you can dream up. So what am I supposed to do? Suffer? Not be able to hold down a job? The term “Cadillac” tax plan is insulting. It is simply a decent health care plan that everyone should have access to. If we can find money for subsidies for corporations, and expensive military airplanes that don’t work, I’m pretty sure we can find money for decent health care!
Face it. The ACA, ("ObamaCare"), stinks. The non-existent Republican plan will stink if if it ever materializes. Here is MikeCare. It almost doesn't stink. You know how the government pays to provide us with universal necessities like cops, education, libraries, road construction and repair, fire departments, snow removal, defense, garbage removal and the like? That's what we need in regard to medical care to make sure that everyone in the country, regardless of wealth or income, is covered. Just like with the other services medical services should be paid for using the taxes which we pay.
Mr Chang Shih An (CALIFORNIA)
Pelosi is owned by the "Squad" She can't do anything anymore but sit on the sidelines as the Democrats veer to the extreme left. Never mind this tax killer of Obamacare. OAC wants to give free entry to the USA for everyone south of the border and give them all free health care education and housing. Americans will have to pay 100 trillion for her ideas.
Jarett (Hoboken)
david (ny)
The flaw in this discussion is that market forces should be used to reduce health care costs. The demand for health care is inelastic. When you need a drug or a procedure you need it. The patient is in no position to decide if a lump is cancerous or if his /her blood pressure /cholesterol needs to be checked. Do we want to use ability to pay to decide if a patient should seek treatment. Other countries have lower health costs because the government controls what providers may charge.
Chris (DC)
@david Exactly! This is to say nothing of the inability for somebody who's just had a stroke or a MI to "research" the cheapest and best providers to help them take care of their emergency situation.
JimmyMac (Lake Hopatcong)
How could anyone of our elected representatives be trusted to do the right thing for Americans and healthcare. The benefits they arranged for themselves are solid. Benefits few of us, their constituents, will ever see. So, although I've seen the word hypocrisy in many comments, it's really our congressional representatives being pigs at the trough.
Chris (DC)
Democrats might as well just allow Republicans to dismantle what's left of the ACA. Pelosi sure hasn't done much of anything to protect it. This tax could have been reformed rather than abolished completely, and Democrats didn't even try. This is why Trump's probably going to win in 2020. Pelosi and senior Democrats have done nothing but demoralize their own base.
B. Rothman (NYC)
@Chris. So this means that you’ll vote for the racist just because the Dems caved on a tax for people who don't buy Into healthcare — and a tax that won”t go into effect until 2022?
Chris (DC)
@B. Rothman No, I won't. Neither will a majority of Americans. Just like a majority of Americans didn't vote for Trump last time. The problem is one of turnout. If there's a large turnout, Democrats usually win. Pelosi hasn't done much of anything to enthuse the Democratic base since taking over the House in 2018. Democrats won't vote for Trump, but they may stay home, particularly younger voters who are much more progressive than Pelosi.
Patrick Borunda (Washington)
@Chris Chris, unfortunately I have to agree with you. Not just on this vote, but on the creeping perception among us that the Democratic House is not actually willing to take the fight to the Repugs and express the consequences of our current slide. As much as I admire Pelosi...she is letting this get out of hand and will precipitate a non-show on what should be a tidal wave in 2020.
Allan (Vancouver, Washington)
There never were Cadillac health plans, just insurance and health care execs driving Cadillacs.
Jim Miller (Old Saybrook CT)
This is absurd. Heath are benefits are income to employees and should be taxed as such.
Kassis (New York)
@Jim Miller If you find this absurd what do you think of corporations paying no taxes at all?
Stevenz (Auckland)
Too much to expect that the democrats could have used this as a bargaining chip?
Elfego (New York)
Before Obamacare, I paid $18,000 a year for coverage for my wife and me. Now, I pay $28,000 for the same coverage. Explain to me where my $2,500 a year savings went, please? Obamacare is a nightmare. The nightmare must end. Just go back to the way things were before, PLEASE!
B. Rothman (NYC)
@Elfego. It went to the insurance companies and to the pharmaceutical companies and to their tax cuts from the Republicans. This is no mystery.
David Sacco (Darien CT)
@Elfego Before Nobama care I paid $12,000 a year with a $6,000 deductible now I pay $19,000 with a $12,000 deductible. Thanks Barry and Sleepy Joe!
Kathleen880 (Ohio)
@Elfego: No, it went to cover the low-income, uninsured, and the middle class is paying for it as we always do. That may or may not be a good thing, but let's at least be honest about it.
Common Sense (Brooklyn, NY)
Shameful! Repealing the Cadillac tax of ObamaCare is exactly the type of chicanery that Americans are fed up with from our elected 'leaders'. And this goes for both sides of the aisle - Democrats for using it as part of the scam to ram through ACA and Republicans for now not holding the opposition to task for what this tax would have meant to working class Americans. The Cadillac tax may have actually been what Republicans have long stood for - allowing real market forces to come in to the health care as employers forced the mega insurance companies and providers to offer cost effective, transparently priced a la carte insurance and services. If the market proved a failure, it might then have been the impetus for the US workers to rise up and demand moving to a national health care system. But, leave it to Washington DC to take a bad situation and make it even worse.
Mr Peabody (Brooklyn, NY)
@Common Sense The Democrats never had any intention of enacting the Cadillac Tax -- It was just a ruse to trick the OMB people to make the numbers work. Because if they really believed in it, they the Democrats would not have continually delayed it. Don't blame the Republicans for this.
Charles (New York)
@Mr Peabody The same thinking that brought us the notion that cutting taxes would boost the economy, increase tax revenues, and lower the deficit. Ha! Sorry, but I'm sick of all of them in Washington.
Paul (Phoenix, AZ)
Pelosi put about 4 nails in the Democratic coffin in roughly 2 weeks. At this rate, they won't even make it to 2020.
B. Rothman (NYC)
@Paul. Meanwhile, the biggest holes in the ship of state have been put there by McConnell who will never bring a bill to the floor unless it suits corporate America and builds a Right wing court while trashing Constitutional directives, and by the racist in the WH who only knows how to antagonize people who don’t kow-tow to him. How is this different from any other authoritarian government? I agree with your conclusion but not with your idea of who is responsible.
Chris (DC)
@B. Rothman He's not saying McConnell isn't a problem, or that Republicans in general aren't a problem. You're missing the point of what he's saying and what I said in my comment. As was illustrated by the 2018 election, and the fact that "Medicare for all" isn't a dirty term on the campaign trail in 2019, the Democratic base is becoming far more liberal than Pelosi and other senior Democratic leaders. I forget whether it was the NYT or WaPo that ran this article, but one of them recently ran an article on the election of 1980 being the reason Pelosi, Biden and senior Democrats are afraid of being accused of being "leftist" or "liberal." The Democrats got their electoral clocks cleaned in 1980 because of Reagan and accusations like that. Democrats will get their clocks cleaned in 2020 if Pelosi, Schumer and other senior Democratic leaders don't stop caving in on issues like this. They might have lost a battle at reforming this tax in some way, but at least they could show they tried. They didn't even try on this one. That's very demoralizing to younger Democrats who are very clearly more progressive than Pelosi. If those younger voters stay home in 2020, Trump wins.
Paul (Phoenix, AZ)
@B. Rothman OK what is Pelosi and the Dems doing to leverage electorally what McConnell is doing? See what I mean? Every time the Dems are handed a potential winning issue, as you describe here, they don't use it.
Kurt (Chicago)
Has anyone checked to see if Pelosi is still a Democrat? Cuz she sher don’t act like it.
AG (Sweet Home, OR)
Democrats kill Obamacare. Wonders never cease!
Larry (Richmond VA)
It might have been a Cadillac tax when it was conceived, but since its basis rises only with general inflation, not the higher inflation rates associated with healthcare, it would have been a Buick tax by the time it took effect, and soon would be a Chevy tax, enforcing the upper limit of most if not nearly all employer-based benefit plans. If it were set at a more reasonable level, say 10% or even 20%, it might have survived, but 40% is confiscatory, higher than the highest income tax rate paid by billionaires. It is just so mean-spirited and condescending, mostly not intended to raise revenue, but to give employees the message that their health benefits, so painfully won over so many years, are more generous than they deserve. I'm a "deficit hawk". I think all the Bush tax cuts, including those on the middle class, should be repealed, and that the Clinton levels of tax enacted in 1993, before the capital gains tax cut, should be restored. I think the gas tax should be at least $1, and that all financial transactions should be taxed. But I'm still against the "Cadillac tax".
C (United States)
Oh my! You would be surprised to learn what has gone on in the health care system here in the United States for a long time.The doctors know the pharmacist knows the drug companies know the AMA knows and all the politicians know. It’s called,kickback.
John (CA)
Now demonstrating the left can be just as foolish, if not as dishonest and usually not as corrupt as the right.
Farida Shaikh (Canada)
I have no idea what Speaker Pelosi is doing.
M (CA)
Wow, I'm getting tired of winning.
jaxcat (florida)
Why worry about our foes taking America down, we do it so well ourselves.
David Martin (Paris)
This is what bad government is all about. Look around in the present and the past at nations that had bad government for too long. History is full of them, and even the present. The ending is never very pretty.
Arthur Taub MD PhD (New Haven CT)
Skilled workers in complex industries have bargained collectively for painful years with their employers for full, appropriate, health care benefits. For political purposes, the Obama administration contrived to steal those benefits from them to finance its misbegotten, steamrollered, agenda-driven, agency-managed, pseudo medical program, skewing all of medical practice to its detriment, and to the detriment of patients. It did this by demonizing as "Cadillac" what had been, step by step, earned, a fully adequate insurance plan, in order to provide meager and unearned benefits to its hoped-for constituency, and to further government control over medical practice, as a crypto-Socialist wedge. The easiest way for a demagogue government to pay for a program is theft, which has finally been recognized for what it is. "Obamacare", if continued unmodified, will cost real money, and those who receive its benefits must pay for it, as all those who receive benefits must. The damage its political intrusion into the practice of medicine has wrought may take decades to repair.
B. Rothman (NYC)
@Arthur Taub MD PhD. Doctor, you have forgotten that before the ACA the biggest cause of middle class bankruptcy what catastrophic healthcare costs not covered by insurers as soon as you applied for them. If the ACA isn’t working as well as it should that’s because of the many ways that private companies and individuals can escape having to pay for coverage, leaving the bill to be unceremoniously dumped on the public without their pay in! Furthermore, lots of the rules concerning the notes that doctors take to the way insurance requires that prescriptions be written are time consuming and counter productive. Lots of doctors are also not that brilliant either.
Joel Carper (
It is absurd to think employers would pass their health saving onto their employees. Secondly, employers have already been slowly "trickling away" health care benefits by increasing the share employees pay. How can anyone seriously believe any employer would do anything but look to their bottom line.
Greg (US)
The ACA caused health insurance rates to explode. Why does anyone contend it made rates cheaper? I now pay 1/3 more over what I paid before this farce of a law took effect. It is a superbly flawed initiative and has only made it more difficult to afford healthcare. The ACA needs to be eliminated and a single-payer system implemented. If some wish to keep private insurance with its deductibles, high premiums, and system of deny first, then let them. All others will receive the care they need WHEN they need it.
centralSQ (Los Angeles)
@Greg I think some people pay more under the ACA, some less. And a lot more people are covered. I pay more. But if they're trying to instill some equality and broader coverage in the system, there has to be winners and losers.
Tiger (USA)
Cool! I agree with getting rid of the tax for two reasons. First, it focuses taxes on something that should not be taxed, healthcare. You don't tax healthcare, you tax corporations. Second, it's not going to save money. People with expensive healthcare plans have added access and benefits, and these perks are likely to improve their health and keep them out of hospitals. Imagine if all plans were plans with wide-ranging benefits, that would be ideal. To actually improve healthcare rather than aimlessly adding patches to a broken system. If you need revenue, tax the rich (with capital gains tax, income tax, etc.); and if you want to improve access for the poor, do it right! Public option.
Jp (Michigan)
@Tiger:"you tax corporations" Corporate taxes like tariffs are passed on to the consumer. But it does make for a good polemic.
John (CA)
@Tiger That's a fantastic opinion as long as you live in a land of fairy tales. In the real world, medical care is expensive. In America, it's extremely expensive, driven by the right claiming death panels, by the sick and elderly, using medical care with little and no benefit, and by all of us, demanding every latest and greatest care choice, no matter how expensive. So yes, tax the wealthy. Demand your "right" to health care. As long as you stay in your fairy tale and don't ever visit reality, you will be safe.
G (Maine)
Sadly a “Cadillac” plan provides “Chevy” coverage in 2019.
Hal (Illinois)
No change: Lower and middle class Americans continue to suffer as the the rich get even more insanely rich. Healthcare is the #1 financial drain next to your mortgage or rent. It is sickening how ALL politicians who all have gold plated healthcare for themselves and their families dish out nothing for the people who put them there year after year decade after decade.
Doug Karo (Durham, NH)
I suppose the new Democratic candidates' healthcare slogan now will become 'Medicare for all except for the privileged who deserve expensive health insurance plans paid for by others'.
Scott (New York, NY)
Health insurance went up 18% for us next year. These hikes have happened every year for more than 5 years. Someone please explain this to me. I don't understand, and I'm a doctor. Where is all this money going?
Lilly (New Hampshire)
Not for actual healthcare. My PCP is crazy with frustration over seeing his beloved, long term patients have to refuse care over and over because the financial institution that masquerades as something else, is increasingly denying everything he prescribes.
Frances (new York)
Lots of votes tonight before Congress goes on another vacation. Where is the NYTimes coverage of the two Republican Senators blocking the adoption of the continuing aid to 9/11 heroes. This is a New York City story. Those two Senators, Paul and Lee should be invited to visit NYC fire stations to explain their votes, and they can bring along the truly evil Mitch McConnell with them. I urge folks to call Paul's office and voice your displeasure.
From Where I Sit (Gotham)
They’re blocking unfunded programs. Make equivalent spending cuts elsewhere and the bill will sail through.
Dkozin (Los Angeles,CA)
@From Where I Sit Seriously, let them unfund the military or raise taxes on capital gains so we can help true heroes who selflessly gave aid to anyone of any ethnicity or color on 9/11 . Even having this conversation is a disgrace .
Barb the Lib (San Rafael, CA)
I read some of the comments below, seems like 7 out of 10 are from Conservatives or Republicans. Why should I listen to these comments? The Republican Party has NEVER done anything to help Americans get affordable health care. They spend all their time trying to get more money to the rich so the rich and fund them and taking away programs that help our country. When a Dem gets elected President we should build on Obamacare, get the mandate back and hopefully get our souls back.
Lilly (New Hampshire)
ObamaCare is what got us here, by keeping the financial institution that profits from denying care in control.
MJG (Valley Stream)
Or maybe, just maybe, they're normal people with families who have seen their healthcare decimated by Obamacare. Maybe liberal ideology isn't always correct.
Chris (DC)
@MJG They're very clearly Americans who don't care about a large number of other Americans who either could not get health insurance at all under the old system or only could get worthless plans that covered nothing. Unfortunately, Republicans have seemingly successfully made an argument that the social contract shouldn't exist and that greed is good. The ACA was and is an effort at combating that terrible world view.
Brian (Baltimore)
Odd how all the Dem presidential candidates want to eliminate private medical insurance and replace it with Medicare for all. This proves there is zero chance of that happening. Let’s ask the candidates to discuss plans they know they can and will implement. Wait....oh, we know that will not happen.
yulia (MO)
Let's wait until healthcare bankrupts us all, then we'll start looking for solutions.
SRF (New York)
As it happens, I've just returned from an appointment with a “health care navigator,” a concierge for ACA health plans. What I learned is that the insurance companies are offering me an opportunity to give them thousands of dollars in return for no health care. With a $4,000 deductible in addition to a $420 per month premium (the cheapest possible “bronze” plan in New York), the insurance on offer wouldn't cover anything but an emergency. And in an emergency, the post-deductible costs would very quickly bankrupt a middle-income person. For an extra $200 to $400 per month you can get a “silver” or “gold” plan, but who can afford that? And there are still deductibles that have to be met each year. It's a system designed to increase profits for insurers, not to provide health care for Americans.
Nancy G. (New York)
It’s for that reason exactly that I have chosen not to buy.
Howard64 (New Jersey)
Probably the most generous plans go to Congress and all government workers. is the government going to tax itself?
Jazz Paw (California)
More money thrown at employer-sponsored plans while individual policies get worse and more unaffordable. This move is in exactly the wromg direction. They should be taking away some of the tax deductions for employer-sponsored plans and using some of the tax savings to level the health insurance access between those with employer plans and those who have to buy their own plan.
Corey (Iowa)
I agree with your observation about the inequality between the group and individual health insurance markets. I think the ACA helped bring coverage to a lot of previously uninsured people, but this group is disproportionately sicker, and they all ended up in the individual market. As a result, premiums in the individual market increased at a much greater rate than the group market, and if you did not qualify for ACA premium subsidies, you paid the entire premium which (in my experience) increased between 30% and 50% per year. Compounding the problem were decisions like Obama's to extend the grandfathering of ACA non-compliant policies, keeping healthy people from having to enter the individual marketplace pool, and people like me who escaped the individual pool for the healthier group pool by turning our family business into an S-Corp and thus qualifying for a group policy of one. If we hadn't made this move, our family policy through the individual marketplace would have been over $2000 per month with a $13K family deductible. I think the failure to share the burden of the sickest people across both the individual and group market pools, and the ramifications of this, seems to support putting us all in one big pool, and it sounds like single payer to me.
I still don't understand why The USA culture think they have two party system. In the last 30 years there has been a 1.5 party system: Rep and Rep Light (aka Dem) We need at least two more party but the Political Machine that runs our lives won't allow it. We are entrapped in a nightmare of our own making. By letting them run our lives and tell us how to think and how to vote we are their slaves that serve them. Let's presidential election will actually be...REP V REP Light. Nothing else. The medial will not speak about anything else. If there is a better choice out there, most be people will be scare to rock the boat. Fear is real. If is not it will be made real. How is that for reality? We will be doing this dance over and over like Groundhog days...but with many generations. One generation will die and the consecutive generations will keep on playing. People, England Canada and other countries have Health Care for their people. One most ask why is the USA don't? We waste resources. We are so good at it that we consume more than 3 or 4 countries put together. As a culture we don't have our priority straight. It is sad but is true. We believe if we don't spend money and have debt the economy will fall, plain brainwashing. We are not about people, we love and hate our corporations. If we didn't, they would be out of business a long time ago or change their way. Why should the parties change? The corps run the parties. We just play at voting.
Lilly (New Hampshire)
That’s why I dem-exited after a lifetime of devoted brainwashed devotion. #ProgressivesMilennialsIndependentsOutnumberCorporatistPartyMembers #PartyPoliticsOnlyHelpsTheRich
itsmildeyes (philadelphia)
Re purported waiting lines in Canada: I tried to make an appointment with with a dermatologist today to look at a growth along my jawline. I couldn’t get anything until November. What else you got?
Lilly (New Hampshire)
Same here. Had to wait six months to see a dermatologist. And when I go, I will be charged $350. And I pay more than $1,000/month for the illusion of being ‘insured’.
Nancy G. (New York)
Has been my experience as well. It can take several months to see some specialists.
617to416 (Ontario Via Massachusetts)
Joe Biden is running on preserving the ACA at the very same time his own party is dismantling it. The ACA was a nice attempt at solving a problem, but its a Rube Goldberg machine. And effective solution has to simplify health care, not increase its complexity. Single payer is the answer—and yes that means phasing out private insurance—but moderates are afraid and conservatives cry "socialism," so American are probably condemning themselves to maintaining their expensive and ineffective health care system for decades to come.
Russell (Chicago)
Who is going to pay for all this!? Is there no one in congress with a backbone?
rjs7777 (NK)
If no one agrees to pay for it, then the program should end. I think cash-only medical care makes sense. And a system of charity hospitals or lesser quality for those who cannot pay. That was the system we had before and it worked much better.
itsmildeyes (philadelphia)
I guess you’re not old enough to remember when people would drag around little kids with leukemia making public appearances to raise money for their treatment.
Earthbound (San Francisco)
@rjs7777 You are out of your gourd if you think cash based medicine would not allow many thousands of people yearly to just die. And how would we fund sub-standard care at charity hospitals in such a political climate?
Woodsprite (poppy)
@rjs7777 Even currently, inability to pay health care bills is a leading cause of bankruptcy,and a leading cause of homelessness.
Hari (Yucaipa, CA)
One way to make it attractive is to mandate all legislature representatives and EVERY citizen gets the same universal health care from the same rationed system, no jumping the line or influencing to get special treatment. So, if you are John Doe waiting for that knee surgery in about 28 weeks, Senator Jane Doe needs to wait her turn 28 weeks for a similar kind of surgery, something that is a reality in Canada where waiting for months for procedure is the NORM.
lzolatrov (Mass)
Gosh, seems like a great way to persuade more people to back Medicare For All; maybe that's the plan though I doubt it. Still, whatever it takes so we finally can have a healthcare system that covers everyone.
Matt (Louisiana)
Maybe we need to reinstate the law that hospitals can’t be for profit. We never had this problem before the repeal of that law.
sam finn (california)
Even before Obamacare, employer-provided health plans enjoyed two significant government benefits that are not generally recognized --- First -- the value of the employer-provided care was not taxed to the employee -- unlike other compensation. Generally, under the income tax law, all compensation -- whether "cash" or "non-cash" -- is taxable. But health care coverage provided by the employer is not taxable to the employee -- even though it clearly has value. This tax benefit was started by the government in World War II as a way to soften wartime wage-price controls -- get the employers to provide health care (instead of wage increases) as an incentive to attract laboring the tight wartime labor market -- but let them both -- employer and employee -do it in a tax-free way. Of course, it was a government giveaway -- and like all government giveaways, it proved very hard to cancel -- even after the end of wage-price controls at the end of the war. Second, starting with COBRA (which was a mishmash of tax and fiscal goodies) in the 1970s, employer-provided health care plans that wanted to enjoy tax-free status (see above) were prohibited from imposing variations -- in either coverage or in the employee contribution -- based on "pre-existing conditions" -- common parlance for what is technically called "medical underwriting". The theory was that with a large pool of insureds, the cost of treatment for many pre-existing conditions -- which can be exorbitant -- is spread.
Adam (Tallahassee)
Contain the costs of healthcare, don't limit the amount of insurance people can obtain.
Auntie Mame (NYC)
Democrats? Are there any at all? Unions also promote lots of bad behavior -- look at the university unions and how adjunct faculty members are treated. Most of what I see can be categorized only as "corruption." BTW another way to avoid the tax altogether is to institute universal single payer... and yes Virginia, everything has repercussions and unsettles until it reaches stasis. BTW I don't get this notion of permanent anything besides the Constitution which can be amended in terms of law. That assumes things don't change. Repug or Demcat -- if you vote for a permanent law, you are the problem. Unbelievable nonsense... and sadly typical. Name names before the vote on which Dems intend to support this new outrage. (Another eg. where Obama was wrong...Kicked the can down the road....)
sam finn (california)
Even before Obamacare, employer-provided health plans enjoyed two significant government benefits that are not generally recognized --- First -- the value of the employer-provided care was not taxed to the employee -- unlike other compensation. Generally, under the income tax law, all compensation -- whether "cash" or "non-cash" -- is taxable. But health care coverage provided by the employer is not taxable to the employee -- even though it clearly has value. This tax benefit was started by the government in World War II as a way to soften wartime wage-price controls -- get the employers to provide health care (instead of wage increases) as an incentive to attract laboring the tight wartime labor market -- but let them both -- employer and employee -do it in a tax-free way. Of course, it was a government giveaway -- and like all government giveaways, it proved very hard to cancel -- even after the end of wage-price controls at the end of the war. Second, starting with COBRA (which was a mishmash of tax and fiscal goodies) in the 1970s, employer-provided health care plans that wanted to enjoy tax-free status (see above) were prohibited from imposing variations -- in either coverage or in the employee contribution -- based on "pre-existing conditions" -- common parlance for what is technically called "medical underwriting". The theory was that with a large pool of insureds, the cost of treatment for many pre-existing conditions -- which can be exorbitant -- is spread
Scythian (Parthia)
Why did the House and Senate refuse Obama Care for themselves to preserve their Cadillac Care?
Jackson (Virginia)
@Scythian. Obama exempted them, something you seem to have forgotten.
Piddy (North Carolina)
@Scythian Fact Check - It's not that simple.
Mike Iker (Mill Valley, CA)
The tension between employment-based healthcare insurance and more inclusive and robust publicly-funded healthcare insurance makes this kind of discussion inevitable. This specific issue - the Cadillac tax - points out the impossibility of taking away employment-based insurance from the tens of millions of Americans who already have it so that one version of Medicare For All can be funded. So let’s get on with the real discussion - providing good quality, comprehensive healthcare insurance to those who don’t have the employment-based insurance option. Let’s make their lives better and obtain some reduction in overall healthcare expenditures in the USA by avoiding some problems that could be avoided through proper preventative care. That kind of proposition - whether through expanded Medicaid, a subsidized public option or other positive measures - is a winning argument for Democrats in 2020 and beyond. Reducing the quality of the healthcare insurance of some people to make them more equal to others is a losing argument. You can fight off the claims of “socialism” when you are providing an essential service. You can point out the success of Social Security and Medicare and Medicaid and challenge the GOP to take those programs away. People can get that. But the cries of “socialism” will find a vast and accepting audience if the perceived goal is taking the wealthy down. The goal is making them pay the bills for social equity, not punishing them for being wealthy.
Consuelo (Texas)
Before we tweak any more of the things inside the black box-like who gets taxed-we need to see what is in there. I agree with those who say that transparent pricing is fundamental. And that should be one reasonable, logically calculated price for the service or procedure. It should not be one price if you have the " Cadillac " plan, a different price if you have good employer paid coverage, another price if you have skimpy employer coverage, another price if you have a decent ACA policy and another if it is a horrible ACA policy. The latter exists by the way. Right now upfront transparent pricing is misleading if everyone is still quoted and still expected to pay " their" cost; a widely varying cost. When are we going to admit that the cobbled together pastiche that we have ended up with is neither fair nor affordable ? Neither is it logical or efficient. It is not fixable with so many wanting to protect their income streams at the expense of the person needing treatment. Indeed they tell you you may not bring your anti hypertensive medicine to the hospital and then charge you $15 for one pill or forgot to chart it and can't give you one even though you have a bottle of 30 at home for which you paid $2.40. And another thing: salaries will not go up if private employers pay less for your health coverage. Just because someone posits this does not mean we should believe it. Maybe if we had government managed single payer & a more equal playing field.
John Doe (Johnstown)
So now I’ll have to pay taxes on the money my public school district pays for the medical benefit I receive, which because I get they’ve told me for all these years is the reason they got away with paying me a lower wage? Thanks, Barack. Nice to know you said you had my back. Of course, you said a lot and not much else.
Ana Luisa (Belgium)
@John Doe Obamacare insures 20 million more Americans, thereby saving an additional half a million American lives a decade. It also curbed cost increases. So obviously, Barack had your back.
John Doe (Johnstown)
@Ana Luisa, the only way for him to get his hand in my back pocket, obviously.
Derek Muller (Carlsbad, CA)
@Ana Luisa Name one actual life the law has saved...
Kingfish52 (Rocky Mountains)
This is just one of the ways that the Democrats in charge of the Party have become Republicans-In-Dem-Clothing. This was a provision that no traditional Democrat would have ever proposed, let alone implemented, placing the burden of cost containment on those least likely to be able to control them: people at the bottom in need of care. It underscores how far the party drifted from its FDR, "little guy" roots under Clinton's Third Way philosophy, which was really just Republican-lite orthodoxy. The ACA itself is right out the Heritage Foundation - a conservative think tank - playbook! It was even implemented in Massachusetts by a Republican Governor, Mitt Romney! And despite that, did not receive ONE Republican Congressional vote. This gives lie to the "excuse" by Obama and the DNC that "We couldn't have passed a Single Payer bill because Republicans wouldn't have voted for it!". Wrong! The Dems controlled all three branches and passed the ACA without any Republican support, so yes they could've passed MFA if they really wanted to, but they didn't. They were in the control of the same Big Healthcare/Big Pharma lobbyists as the Republicans, and most still are. The plain fact is that health care costs are one of the biggest burdens to most Americans, but rather than fight on the side of the 99%, the Dems have abandoned their commitment to the working and middle class. It's about time that some of them have remembered.
USNA73 (CV 67)
@Kingfish52 Total control” of the Senate requires 60 Democratic or Republican Senators. On January 20th, 2009, 57 Senate seats were held by Democrats with 2 Independents (Bernie Sanders and Joe Lieberman) caucusing with the Democrats...which gave Democrats 59 mostly-reliable Democratic votes in the Senate, one shy of filibuster-proof “total control.” Republicans held 41 seats. The 59 number in January, 2009 included Ted Kennedy and Al Franken. Kennedy had a seizure during an Obama inaugural luncheon and never returned to vote in the Senate.....and Al Franken was not officially seated until July 7th, 2009 (hotly contested recount demanded by Norm Coleman.) The real Democratic Senate seat number in January, 2009 was 55 Democrats plus 2 Independents equaling 57 Senate seats.
gus (new york)
@USNA73 actually they had 60 seats eventually after the Alaska recount (Mark Begich) and the Al Franken recount (MN -- he was seated in June 2009) was finished, since that seat went to a Democrat eventually. The majority was 60, filibuster-proof, until Ted Kennedy's seat was filled in early 2010, which went to a republican, Scott Brown. But if 20 of those 60 seats are DINOs (democrats in name only), and one has to bribe them with all kinds of pork to vote for the law, then it's no surprise that nothing great came of it. The failure was in leadership -- if Obama had aggressively pushed Medicare for All it could have passed. But perhaps it might have been so unpopular (most likely actually) that it could have doomed the party for decades.
USNA73 (CV 67)
@gus You fail to acknowledge Kennedy's absence. Holding a "seat" not able to be present to vote is meaningless. Check the Senate record on when Kennedy was absent.
jerseyjazz (Bergen County NJ)
Amen @Tom Meadowcroft: "Doing away with the Cadillac tax is a handout from the Democratic party to their paymasters in the big unions." If NJ public unions would accept Gold level instead of Platinum, the state would save millions. Meanwhile most NJ private workers and employers struggle to hold onto Bronze and Silver levels with high deductibles. Last year a public schoolteacher friend in a town in northern Bergen County paid $2 for a prescription that used to cost me $200. Yet she complains she has to pay 20 dimes out of her own pocket. Yes, teachers pay taxes too--but those dollars flow back to them, their spouses and their kids up to age 26, in virtually free health care that the rest of us can scant afford. I thank God every day I'm finally on Medicare this year. But Cult 45 will go after that soon too, and then we'll see whether "the base" is as ignorant as they seem to be.
James Noble (Los Angeles)
Since employers already pay premiums, I recommend that they increase salaries by the amount they pay for health insurance. Employees could use the extra income to offset taxes required to pay for a government program plus some funds to pay for what a Medicare program doesn’t pay.... approximately 20 percent of certain charges. Obamacare is too complicated.
Ana Luisa (Belgium)
@James Noble Too complicated? Tell that the additional half a million Americans a decade whose lives Obamacare saves. What shocks me in this debate is how many people seem to think about healthcare in a totally abstract way.
yulia (MO)
Not in abstract ways. Although it may save some lives, but it definitely didn't make health care affordable for many people. And it is complicated, because in the beginning of the year, you need to predict what will be your income and could you count on subsidies and how much subsidies you can get. With gig economy such predictions. are complicated.
EPMD (Dartmouth,MA)
The idea is to improve and modify the ACA and if this does that it is okay. The republicans have destroyed the notion of worrying about costs and our deficit. We just gave billionaires, corporations and foreign investors huge tax cuts at our own expense. So this modification is irrelevant in terms of costs, the republicans claim our economy will cover the additional cost of everything they do—so why should the Democrats worry about them.
JOSEPH (Texas)
Single payer will not increase access to medical care. It will lead to a 2 tier system. One for the rich & powerful elite and one for the masses. The masses will be subjected to extreme wait times, rationed care, etc while the rich elites will get everything. Remember how government representatives were exempt from Obamacare? Not to mention less people will be inclined to go into healthcare as a career.
Montreal Moe (Twixt Gog and Magog)
@JOSEPH There are 36 million people North of you who will tell you this is utter nonsense. Healthcare workers are respected and well paid in our society whether they mop floors or perform intricate surgery. Of course we are not Texas but second province to offer single payer hospital insurance was far right wing Christianists who back in 1947 asked What would Jesus do?
Christian Haesemeyer (Melbourne)
Nonsense. Double nonsense, because the US system already is a two tier system, at least: people who can afford healthcare, and folks who cannot.
AJ (California)
@JOSEPH Uhhhhh... the insurance for the masses from the private sector leads to extreme wait times and rationed care. That's literally reality right now.
James (Chicago)
The unions are the first to face the issues that would be involved in moving to single payer (Medicaid for All). Current Situation: Earn $70K salary + receive health care plan with actuarial value of $20K = $90K total compensation. Pay $20K tax = $50K net pay. Situation under Medicaid for All Earn $70K salary + $0 health care plan = $70K total compensation. Taxes increased to $30K to cover Medicaid for All = $40K net pay. The issue is how do you get the $20K your employer paid for healthcare added to your Gross income? Union contracts are very rigid, so worker would be worse off until contract comes up for negotiation, and even then getting the $20K added to base salary would be hard. All current employer-insured workers would be in a similiar position. And there would be friction in getting 100% of formerly employer-paid premiums added back to their gross pay, and even if they did recieve 100%, they would lose tax deductibility of heath care premiums and pay higher tax since gross pay is higher. On top of higher marginal tax rate, they would also pay a higher tax to fund Medicaid for All. Taxes would increase on the merely upper middle class to fund "free" healthcare for the extremely poor. The higher your salary, the worse the deal gets.
Mike (NY)
I've said it before and I'll say it again: liberals do at least as much damage to this country as conservatives. You couldn't tell a Bernie Sanders supporter from a Donald Trump supporter for $1,000 three years ago, they sounded exactly the same.
Ana Luisa (Belgium)
@Mike That's objectively wrong. Obamacare insures 20 million more Americans, thereby saving an additional half a million American lives a decade, all while curbing cost increases. Ryancare, that Trump would have signed into law if it weren't for John McCain who five minutes before dying found his moral compass back, would destroy the healthcare of a whopping 30 million Americans, which would cause hundreds of thousands of totally unnecessary deaths. If you can't see the difference between both, imho you became part of those who lost their moral compass too ...
SR (California)
@Mike, not so. I know plenty of Bernie and Trump supporters. There is not one thing they agree upon except their contempt of the other.
Mike (NY)
@SR And every Republican line of attack on the Clinton’s from the 1990s.
Robert Zatkin (Sacramento)
Yet again proof positive that many Members of Congress care far less about "We the People" than they do about pontification, the dissconnect from reality as to their worth to 'We the People", and the accelerating decline and decay of the nation.
Bhaskar (Dallas, TX)
Giving it a nice name - Cadillac tax- was to sound patriotic and as American as it can get. But the truth is deep inside, “the Cadillac tax was intended to force employees to spend more of their own money on high-cost health insurance plans.” The ACA specifically punished those having a job: If you needed a surgery you paid more than before ACA. If you were healthy you paid Obamacare tax on top of your income tax. And here I am at work .. felling like a piggy bank.
Liberty hound (Washington)
Obama pushed for the Cadillac Tax but delayed its implementation (without any legal authority to do so) in order to enhance Democrats' electoral chances.
VJR (North America)
While we have to laud the purpose of Obamacare, we also need to recognize that it was Frankenlegislation at best. The pre-Obamacare healthcare situation was unacceptable so something had to be done, but the post-Obamacare situation is also unacceptable.... but it was a move forward from before. Unfortunately, the real solution to healthcare is revolutionary mix of actions that could not have passed when Obama became President. Thus, we had Obamacare to do _something_ better. But, now that the shock of doing something different has worn-off, now is the time to institute that revolutionary mix and this includes national healthcare - unthinkable in 2010, not so today.
kilika (Chicago)
Deems can't help but keep trump in office. They always shot themselves in the foot.
Montreal Moe (Twixt Gog and Magog)
I am a senior and have both American Medicare and Quebec Health Insurance. It is time to ask Joe Biden to drop out of the race. Half of my paper recyclables are advertisements for supplemental health Insurance from AARP sponsors, other private insurers or Canadian Insurers who fill in the gaps and profit from government's inability to cover every contingency as we age. Biden is either lying or ignorant and as much as we are grateful for all he has done he is a danger Democrats face when they try to get rid of a professional's professional conman and liar who has no problem with the damage he inflicts on his country and the world. What is Biden thinking when he utters such bald faced and easily refuted lies?
Marie (New York)
@Montreal Moe Which insurance is better? Does Quebec cover your prescription medications?
Montreal Moe (Twixt Gog and Magog)
@Marie The government pays much of my cost of prescription meds. The system if tweaked constantly and at this moment our Local University controls health , education and welfare. Right now our less than one year old center right government must deal with 4.4 billion dollar revenue surplus. What is today may not be tomorrow this week our first senior bonus cheques arrived. I don't know if the government will pay the total cost tomorrow. They are threatening us with universal dental care.
tom harrison (seattle)
Dear America: Do you want healthcare for you and your family or...20 more years of war in Afghanistan? Every time someone says Medicare for All the first question is how to pay for it. Well, start with all of the money we taxpayers waste chasing after some guy named Abdul on the other side of the planet in the middle of the poppy fields. Our own Commander-in-Chief can't even spell Al Qaeda because let's be real - they pose no threat to us. But we still guard the opium fields of Afghanistan convinced that someday the women of Kabul will wear miniskirts again. This is the stated goal - women in miniskirts! Meanwhile, back in the states, people are getting shot at school, church, concerts, gay bars, synagogues, and all places in between. People die from heroin overdoses everyday in this country. But we must have miniskirts in Kabul. I don't want to hear a single word from candidates on healthcare or reparations or immigration. I want to hear once and for all who is going to stop that stupid war that is breaking our bank while making people like Cheney even richer. I don't want empty promises of Hope and Change, I want real action ending a war that you and I pay for an effort to bring back the miniskirts of Kabul!
Jp (Michigan)
@tom harrison:"I don't want to hear a single word from candidates on healthcare or reparations or immigration. " Must be tough living in Seattle.
Dan M (Massachusetts)
An aging population means the average American will need an increasing level of health care services in the coming years. How to pay for it is a secondary issue. Expect less direct attention from doctors and nurses as new medical professionals cannot be trained fast enough to keep up with demand. Projections for percentage of U.S. population aged 65 years and over: 2020: 16.9% 2030: 20.6% 2040: 21.7% 2050: 22.1% 2060: 23.5%
LT (Chicago)
If Democrats are unwilling to tax "gold plated" private health insurance plans because it offends important constituencies, how are we supposed to believe they would really be willing to take private health insurance away in a massive switch to Medicare-for-All? It's a complicated political problem but I don't think Democrats are doing themselves any favors when they collectively act like lions on the debate stage and like lambs in legislative chambers.
Ana Luisa (Belgium)
@LT You seem to ignore that Pelosi's House ALREADY passed a public option, in 2010? That's how you install single payer, gradually. All that it takes now is a Democratic Senate and White House, and the next step towards universal healthcare will soon be achieved. That the Democrats accept to eliminate a tax that objective studies prove does NOT make healthcare more affordable, whereas that was precisely the first and main priority of Obamacare, shows that they continue to be passionate about universal healthcare, and are willing to adapt and integrate new studies. It should INCREASE your confidence in Democrats, when it comes to moving towards universal healthcare, rather than lower it ...
LT (Chicago)
@Ana Luisa I haven't forgotten. I agree with you on the suitability and political practicality of the public option, my point is that many Democrats don't and have gone all in on Medicare-for-All: Sanders and Warren, many of the vocal progressives in the House. Harris (until she walked it back). I don't think they have anywhere near the wide-spread support to get to Medicare-for-All in one step, and by showing disdain for the public option or using it as a litmus test to show progressive bona fides, I fear we will get neither.
gus (new york)
@Ana Luisa Unfortunately since it's not the same legislative session anymore, the house would have to pass the public option again, which seems less likely this time around -- not to mention that there would need to be a 60-vote majority in the Senate.
Austin Ouellette (Denver, CO)
Fact number 1: Countries with Medicare for All spend less on healthcare as a percentage of GDP. You can decide you don’t LIKE that fact, but it doesn’t stop being a fact. Fact number 2: Health insurance executives authorize their companies to pay hundreds of millions of dollars to politicians, pundits, lobbyists, and internet/TV ads to kill laws that make healthcare more affordable and accessible to Americans. Again, a person can decide they don’t LIKE that fact, but it doesn’t stop being a fact. Fact number 3: A corporate executive earning $4 Million per year to ensure their company keeps making 30% profit margins, does not care that a 30 year old woman is denied her breast cancer medications and dies. How do we know that? Because if they did care, they’d approve the treatment coverage. Killing the Cadillac tax has nothing to do with helping the middle class. Nothing. It’s a lie. It’s classic abuser behavior. Cancel the very thing that poor/middle class people rely on to afford healthcare, then claim that the cancellation is ACTUALLY designed to help them. How many men convicted on domestic violence charges have said that the reason they hit their significant other was actually an act of love? The answer is too many to count. We need Medicare for All. And we need it yesterday.
Maggie (U.S.A.)
@Austin Ouellette No other country has Medicare/Medicaid. If you mean single payer, then Canada and Taiwan are the only 2 nations on the planet with single payer/universal care. Every other nation has a private-public buffet, as does the U.S. Those other nations also have small populations of under 45 million that are well-educated, mostly homogenous and well-employed, thus able to withstand 40 to 50% tax rates. The 330 million population of America is none of those things.
Meagan (San Diego)
@Austin Ouellette Pretty sure I love you and your facts.
srwdm (Boston)
More evidence that we need to transition to single-payer universal coverage. The richest nation in the history of the world can certainly provide a modicum of health care—like food and water—for its citizens. And using European models, at about HALF of what we're now paying! With the Blight of Trump on its way out, NOW is the time to go progressively forward. A physician MD
Maggie (U.S.A.)
@srwdm No European nation has single payer/universal care, nor will the U.S.
srwdm (Boston)
@Maggie Certainly that direction.
Ana Luisa (Belgium)
@Maggie Wrong. Most of them have it, Belgium (where I'm living now) included. Look it up and you'll see. And today already, even a majority of GOP voters support it too. The US is a democracy. No taxation without representation ...
Change Happens (USA)
Focusing debate on insurance or taxes on insurance is a straw man. This does not address real problems of access to healthcare or affordable care or ballooning prices. Likewise throwing around “single-payer” sounds scary because it implies radical changes to healthcare quality and access for those of us who have it now. Let’s talk about changes that are needed: 1. A government healthcare system (like Medicare) for entire public (who want it) that covers family GP clinic healthcare. 2. Later phase in inclusion of SOME hospital care that covers most common and acute health ailments. 3. Government negotiates drug pricing with pharma for everyone who is enrolled in this system Medicare & Medicaid members. 4. Hospitals must provide transparent pricing (this is required now) in advance of all elective procedures in a format similar to the way consumer affairs made credit card companies overhaul billing statements. Hospitals must provide all-inclusive pricing of most procedures. Surprise billing must end. 5. End of life care among all government programs has a reasonable (tbd) cost limit. This reform alone will save billions and billions of dollars. 6. Add in some type of new lifestyle guided healthcare clinics for chronic diseases (obesity, diabetes, inflammatory illness, addiction/psychiatric etc). This is an excellent starting point Congress / DNC candidate. Let’s make it happen.
David Nelson (Chicago, IL)
It's all about competition and the consumer caring what things cost. Insurance should be for big things like when you crash your car, not routine maintenance. What we have now is like having insurance for gas and oil changes. Of course, provisions would be made for the disadvantaged but the market and competition always makes things cheaper and better.
Craig (Killingly, CT)
Democrats be on the alert that when the bill goes over to the Republican-controlled Senate, the Trumpies will try to add riders or tweaks to continue to undermine the basic law.
William LeGro (Oregon)
"...generous health benefits encourage people to get more medical care than they need." Seriously? That's a concept dreamed up by elitists living on a different planet, divorced from Real Life in America. What percentage of people go to the doctor or hospital more than they absolutely have to? Injections, the smell, machines beeping, co-pays, having to take medications, surrendering control over your body to one professional after another after another, each of whom ask your name and birthdate, and worst, finding out something you'd didn't want to find out - how is that at all attractive to anybody but a small minority? The real problem is that people DON'T get medical care nearly as much as they should. And this tax would pretty much make that problem worse.
Jp (Michigan)
@William LeGro:"Seriously?" Sure. Every once in a while there is a story run in the NYT about how someone became ill in Europe, was promptly seen by a physician, the bill was completely paid and were promptly sent home to recover with no pain reliever other than ibuprofen - if that. The last one I read informed us that pain was natural and a part of life so don't try and suppress it. No pain relief and wards, that's the ticket.
Al (Idaho)
Parts of the ACA need to be modified/changed. That's what we expect the legislators to do. However, the democratic hopefuls last week shot themselves in the foot by calling for mandatory Medicare for all and health insurance for illegals. Someone at the DNC must be staying up at night trying to find new ways to lose to trump.
Donald (Ft Lauderdale)
Healthcare is just one big ripoff. How about we outsource it to a group of successful operators like the Canadians. All paid for in your taxes and done a t competitive single payor rates. What does that mean? No more 26,000,000 salaries for healthcare CEO's No more junkets to 5 star resorts No more sweet deals for ex congressman , (talking about Billy Tauzin). Decency brought back to this country from the grifting 1% Citizens United Criminal Class that Wall Street has inflicted upon us.
Ana Luisa (Belgium)
I regret the fact that the NYT opted for such a sensational headline for this article. As its content shows, in the current circumstances, the only way to honor the intention behind Obamacare (= to make high-quality healthcare affordable to as many Americans as possible) it to now suspend the Cadillac tax. Obama NEVER called the ACA a finished product, but merely a law that lays the FOUNDATION of crucial healthcare reform in this country. It was always meant to be built on, including modifying key parts where necessary. So I'm certain that he would see this bill as an improvement, that goes into the exact same direction as the ACA did a decade ago, and certainly not a "hostile takeover", as this headline suggests. Yes, ideally we build on it all while reducing the deficit even more than the ACA already does. But on the one hand all GOP bills on this issue would do the exact opposite, rather than improve things for the American people, whereas on the other hand Democrats don't have the legal power yet to take the next logical step (Medicare for all). So this is the right thing to do. Go Democrats!!
Michael Wright (Indianapolis)
I’d love to match a list of Democrats who support mandatory Medicare for All with those who support repeal of the Cadillac tax. For those who support both. I say, you’re being disingenuous. You support Cadillac health care until you eliminate Cadillac health care with Medicare for All. Good luck running on that, and don’t ever claim that you want to bring down health care costs.
Vada Marie Hays (Ypsilanti, Michigan)
Benefits are part of the pay package. Workers may accept lower pay for the security of getting health insurance for themselves and their dependents. Taxing benefits would be a low blow to already stressed workers. But people like 45 and McConnell don’t really care, do you?
USNA73 (CV 67)
There will be no magic. The only solution to deliver universal health care is the creation of a single payer system for all but the routine care, combined with a reduction in costs. This includes Rx drugs. Hospitals will need to have salaried docs ( think Cleveland Clinic and Mayo Clinic). Yes, there will be a requirement that everyone be in the pool and it won't be "free." We will pay for this the same way that the rest of the world does: Taxes. By the way, the rest of the industrialized world already does this at half our costs and gets better outcomes. Why the heck is there so much contention over whose ox will get gored. The answer: Too many Americans are expecting magic or simply don't believe that one day they will make a visit to the emergency room. This is delusional. In the meantime, people die unnecessarily and huge sums of money are wasted.
J (Denver)
The bottom line is that we have to stop accepting "better than nothing" solutions, and that is what the ACA has always been... better than nothing. Ideally, we should have universal health care available to anyone who can make it to the counter in a clinic, paid out of taxes by everyone. Charging for health care is extortion because people will pay whatever you ask them to pay... it a true capitalist model, the consumer can walk away from any price they don't agree with... that option doesn't exist in health care, when life and limb is on the line. And the free-market capitalism that runs the distribution of medical products and services is exactly the waste that as a society we complain about... we pay the markup... we pay the middle men... and in the end we pay 10xs what other countries pay to end up behind them on the Global Health and Happiness Index. And then you start to look at automation and what our economy based on jobs will be like when inside 50 years robots can do every single human task... Demonize socialism all way long... in the end, at your own peril... because it's the only solution that answers the very real and almost present paradigm changing realities we face. It's that or food lines, riots, and mass crime.
gh (pa)
Medicare for all cannot happen in one action, and any Democratic candidate promoting that will guarantee Trumps re-election. Instead, we need to institute a public option, as well as a Medicare buy-in for early retirees. Anyone who has lost a job in their 50's, or wants to retire to take care of parents, knows that Obamacare is better than nothing, but not ideal. As for controlling costs, attention needs to be paid to pharmaceutical companies and their massive marketing budgets.
Meredith (New York) pushing Medicare for All results in Trump's election? So a decade from now, we'll hear the same....that reform must be incremental and pragmatic. That means, don't reduce profits of mega donor insurance/pharma. Years will pass. In 2030, If candidates try to bring the US up to 20th C international standards of HC access, we'll hear the same excuses of too left wing radical. The media will dutifully report this, and much of public will be fooled again.
Mathias (NORCAL)
@gh Wouldn’t it be better to have young people in instead of off loading everyone older where most of the expenses are. Do it right. Everyone in. You can keep your insurance on top. But everyone is covered. None of this game the system as we saw with the ACA Republican poison pill plan.
J. Waddell (Columbus, OH)
Of course it's the Cadillac tax that is probably the best part of Obamacare. As long as employees think they are shielded from the costs of health care there will be no incentive by providers to hold down costs. What they don't realize is that the high premiums "paid" by their employers end up coming out of their wages. (Even Paul Krugman acknowledged this in an old column noting that we had to include employer paid benefits in calculating real wage increases.)
Charles (New York)
@J. Waddell "What they don't realize is that the high premiums "paid" by their employers end up coming out of their wages."... Of course they realize this. They also realize it is a tax free benefit. An increase in wages to pay for health insurance is not, by any stretch, an even deal.
Sailorgirl (Florida)
If we want to get a handle on escalating medical costs we need to start with the cost of medical education. A doctors debt through his or her fellowship is capitalized when they enter practice. We can never bring down the cost of medicine until we bring down the cost of medical education. Start with graduate school debt financed at the cost of 10 year treasuries 2.05 vs 6.08. We should also move to a six year med school program including undergraduate like they do in Europe. People apply to fellowships and graduate programs based on need and skill level. With so much debt high earning specialties are in demand where shortages exist in primary, pediatric and elder care. Not for profit hospitals need to be not for profit. That goes for high paying administrative costs and build it and they will come programs. Private equity returns on urgent care and outpatient facilities needs to be capt as well as doctor investment. Controlling costs starts with the high cost of medical school and expanding the number of medical school seats to meet the population needs of our country.
Bryan (Brooklyn, NY)
@Sailorgirl Kind of one sided there. The day-to-day cost associated with being a Dr. is almost cost prohibitive. You forgot to include the exorbitant malpractice insurance costs that doctors have to pay for and the fact that a Q-Tip at the drug store cost 0.01¢ and $8.00 in a hospital.
Meredith (New York)
@Sailorgirl... So tell us what med students pay for tuition in Europe for their 6 year med school program. How does their lower tuition translate into lower costs for patients they later treat? How does tax supported tuition and health care result in lower costs for citizens? How much do doctors have to pay for malpractice insurance---under single payer, orunder insurance mandate systems, where the govt regulates premium prices for the public.
Stephen Merritt (Gainesville)
OK, there could be a real argument for doing this in "normal" times, especially if a tax on Cadillac incomes could get through Congress and be signed. But given that the Chief Justice voted to uphold the ACA based on it involving a tax, why undermine his position when the ACA will be back before the Supreme Court soon, granted that the Cadillac Tax hasn't been imposed yet. Just having it in the legislation helps to give John Roberts cover. The Chief Justice may find other grounds for upholding the ACA (I very much hope he will), but for now, taking a narrow view of this issue increases the danger to the health policies of everyone covered by the ACA. I don't expect anyone in Congress even to read this comment, nor to be influenced by any other communications I might make, but the point ought to be considered.
Barbara (D.C.)
There could be a blue wave if Dems could get their act together on health care. We can't jump into single payer, be realistic. But the ACA needs repairs, and a clear plan could be a game-changer. The most effective step we could take is to include bottom>up with top>down care. America is too focused on alleviating symptoms with pharmaceuticals and largely ignores root causes. We need plans that look at naturopathy and osteopathy (for example) as effective ways to create better health and curb costs.
Al (Idaho)
@Barbara. They are not only not getting their act together, they are going backwards. If we really think people are at least partially responsible for their own health, we'd be taxing stuff like: alcohol, tobacco, gasoline, bullets, sugary/fatty foods and other things that are causing many (but not all) of our health problems. The effects of bad individual choices are now spread over all of society. Otoh, for example, special interest groups have defeated things like taxes on sugary drinks and obesity and its problems continue to rise.
Erica Smythe (Minnesota)
@Barbara You can't improve ACA without this 40% tax. That's a simple math fact. The reason we have $1 trillion deficits each year is driven from stupid decisions like passing a 40% tax and then kicking to the curb so the politicians who put it in place to get the CBO to score Obamacare....could then play hide the weasel from America. Trump's right. The whole system is rigged.
CJM (Kansas)
@Barbara I'm sorry, but you just combined "be realistic" with naturopathy in the same comment. How about we go for the opposite of Trump-ism instead of adopting the same anti-science hogwash he peddles.
mdieri (Boston)
I agree with the House Democrats to eliminate this tax on insurance plans. Please focus on fixing the ACA by offering a public option, or, better, single payer, which will give government a say in controlling health care costs. Penalizing the ever-decreasing number of employers who offer good health insurance is in no one's interest! Reminds me of other well-intentioned but bone-headed proposals, like taxing 529 plans: pitting the middle class against the middle class because the paper tigers are afraid to raise the low marginal tax rates on the very rich.
Ana Luisa (Belgium)
@mdieri Pelosi's House ALREADY passed a public option, and Hillary ran on it too. It will only be signed into law, though, the day "we the people" engage too, and vote the GOP out, on all levels of government. Yes WE can!!
CJM (Kansas)
@mdieri I don't think you understand what "single payer" is. The whole idea of having a *single* payer is that it would replace the *many* payers we have now--in other words, health insurers. You can't have "single payer" and "employers who offer good health insurance" at the same time. (Yes, of course, you can have all sorts of "public options," but not *single* payer. It's kind of definitional.)
mdieri (Boston)
@CJM I do understand single payer and that is/should be the ultimate goal - offering a public option is a step toward that. My point was not to waste time nibbling around the edges with incremental tweaks to the ACA but to move toward a rational, national health care system.
Roarke (CA)
See, this is one of the fundamental flaws with public-private partnerships, as seen in our health insurance industry under the ACA. In this case, the public good and the profit motive clash really badly, resulting in a law that can't juggle the competing incentives. I don't know if single-payer, government-run healthcare is all that feasible in the US, but I am certain that the current power balance in this public-private partnership needs to tilt away from the insurers.
Erica Smythe (Minnesota)
@Roarke If the politicians in the Democrat Party can't stomach the 40% tax they all voted for less than 10 years well do you think they're going to stomach voting for a $20 trillion tax increase so you can get free healthcare..all while hospitals all over America close their doors in year 1?
Maggie (U.S.A.)
@Roarke Every nation on the planet has a public-private system, save for Canada and Taiwan.
Roarke (CA)
@Maggie And as I said, the balance needs to shift away from the private sector, because they're misbehaving. Right now, the government is socializing cost while the insurers privatize profits. Unsustainable.
Edwin (New York)
This will "balloon deficits by $168 billion over the next decade." Are you kidding? Amidst federal spending somewhere north of 4 trillion a year? Oh wait, this is the New York Times and this is a story about a labor benefit. "Neither party showing much concern for the government’s rising tide of red ink." For shame! Pentagon expenditures and payments to Israel is one thing but Cadillac plans for American workers? Tax free? Madness indeed. Next thing you know we'll be balooning the deficit on things like bridges and rail tunnels, more extravagant sops to American workers.
CJM (Kansas)
@Edwin Recommend x 10
R. R. (NY, USA)
Don't tax you, don't tax me, tax the fellow behind the tree.
Mathias (NORCAL)
@R. R. Or let insurance tax you and offer you nothing while Americans die and others bargain with their lives. Stop the half way house. Medical for all helps small business. It allows us to move freely to employers we choose instead of stuck. We don’t worry about losing medical if we get really sick and losing our future coverage if we end up unemployed because of it. There are so many reasons for single payer. The cost argument doesn’t measure up. We are paying more already! It doesn’t matter who takes that money! We are being robbed! Stop aiding the thieves. They have proven insurance doesn’t want to reform and work with us.
Len Charlap (Princeton NJ)
The Committee for a Responsible Federal Budget is one of Pete Petersen's empire of think tanks devoted to the idea of "fiscal responsibility." By that they mean the federal government should adopt policies that lead to a reduction of the national debt. Their knowledge of economics and economic history seems to be non-existent. Let's see what has happened EVERYTIME we significantly (10% or more) reduced the federal debt. The federal government has balanced the budget, eliminated deficits for more than three years, and paid down the debt more than 10% in just six periods since 1776, bringing in enough revenue to cover all of its spending during 1817-21, 1823-36, 1852-57, 1867-73, 1880-93, and 1920-30. The debt was paid down 29%. 100%, 59%, 27%, 57%, and 38% respectively. A depression began in 1819, 1837, 1857, 1873, 1893 and 1929. On the other hand, in contrast to post WWI which reduced the debt 38% and led to disaster, after WWII we INCREASED the debt 75% from 1946 to 1973 and had average GDP growth of 3.8% and real median household income surged 74%. The article quotes Maya MacGuineas, president of the Committee for a Responsible Federal Budget, who is neither an economist nor an economic historian. That's like asking the head of the Flat Earth Society to comment on the Theory of General Relativity.
R (Washington)
@Len Charlap Yep, though spending money you have should still be a very deliberate step, not the next thing to do because you can't agree on priorities. As someone (?) said very pointedly this morning on the radio, if it's worth it, it's worth spending money on. What would it take the US to let states opt in or out on a single payer system (obviously without dismantling the employer based system entirely?) Is that feasible?
Len Charlap (Princeton NJ)
@R - No. The goal should be an efficient system where everyone's needs are met and cost are not thru the roof. You cannot do that if a significant percentage have private insurance which not only is extremely wasteful in terms of overhead and compliance costs, but which keeps medical data secret so that we cannot have an entity that gathers it, analyzes it and makes medical recommendations based on science, not profit. Read the series Paying Til It Hurts.
Jp (Michigan)
@Len Charlap:"but which keeps medical data secret so that we cannot have an entity that gathers it, analyzes it and makes medical recommendations based on science, not profit." You're statement is not accurate. In your scheme the medical recommendation would still be based on budget. My insurance is rather expensive (I don't use the VA system even though I qualify.) and I have access to care without pre-approval. I don't want it changed. Your not the only one who watches out for their particular situation.
Casual Observer (Los Angeles)
Medicare is funded by working people and taxpayers, not just by the people covered and receiving benefits. Medicare for all will need to be paid by all who are also receiving coverage. The population will include children who are prone to every illness imaginable, the costs of well child and well baby care, immunizations, and all the medical costs of childhood. It will have to cover all the costs of women during child bearing years. It will have to cover the chronic conditions of middle aged people. It will have to pay for all the injuries of risk taking younger people, everyone's emergency care. And it will have to cover all the health care for retired and the elderly. Now, how does a system like Medicare have to be changed to do all of that? Suddenly, one can see that the Medicare for All plan is not a plan, it's a marketing scheme that is not based upon any real program that has been considered seriously.
Al (Idaho)
@Casual Observer. Part of the problem is that the costs of everything you describe is sort of getting done now by a patch work of Medicaid, private insurance, Medicare and medical care that doesn't get covered or bankrupts people. We need to change things but just saying "Medicare for all" is simple and appealing, but doesn't fix things. Easy slogans are fun, but rarely get anything done. "MAGA" and "hope and change" come to mind.
Erica Smythe (Minnesota)
@Casual Observer Medicare is subsidized because the health insurance I have pays 130% of the normal costs so you can get treatment with 60% reimbursement rates to the doctors, nurses and hospitals. Look..there is no Santa Claus. You push single payer with the Medicare reimbursement rates..and all you're going to do is force 10,000,000 doctors to retire tomorrow...10,000 hospitals to close with a year...and the only one who apparently will be happy will be Bernie Sanders because then everyone is miserable..just like him.
Ana Luisa (Belgium)
@Casual Observer Contrary to what you seem to imagine, "Medicare for ALL" IS a plan. See Elizabeth Warren's website for all the "wonky" details, if that's what you're interested in. And I really don't see why you imagine that the wealthiest country on earth somehow would not be able to create a collective insurance fund that allows us to cover all illnesses when all other Western countries have no problem doing so. Conclusion: imho you need to update your info ... ;-)
johnlo (Los Angeles)
Uh huh. It was that provision that allowed the Democrats and Obama to proclaim that the ACA would result in reduced federal deficit spending. All along they knew that they would epeal the Cadillac tax out of political considerations before it became effective. Very dishonest but I'm glad their doing it. As proposed it was very unfair.
Erica Smythe (Minnesota)
@johnlo Bingo. I still hate John McCain for that thumbs down vote. That would have free insurers to write skinnier plans. If you write skinnier plans that are actually affordable, states can impose mandates that require people to have health insurance (as they do with car insurance). Getting everyone insured means you end the freeloader problem and keep premiums managed by having everyone paying premiums..and you don't have a pre-existing condition dilemma because state law mandates you have health insurance in order to get pre-existing conditions covered. Why is this so hard for people to understand? Honesty about fees and the lifestyles you lead simply mean you pay market rate for health insurance if you're jumping out of airplanes, riding bikes down mountains, skiing down slopes and running ultra marathons every other weekend. And enough with the pizza and beer. Grab a salad and glass of water.
Cormac (NYC)
@johnlo I'm not clear on how you get to this: "All along they knew that they would [r]epeal the Cadillac tax out of political considerations before it became effective." How do you know that or what makes you say it? It seems to me more likely that they did not (given how much angst they shed over the provision in the first place) and are now doing a 180 in the face of political consequences. This sort of casual assumption of disingenuousness with evidence is part of what is undermining our free society.
Gordon Jones (California)
Employers response to the Cadillac Tax predictable and disgusting. Stay away from that level of premium by cutting actual health care coverage. Who would have thought? Most people unschooled in the work around process. Those in industry who came up with this, saved their employers big bucks. Cost patients big bucks. Betting that there were bonuses galore. So, if the tax is repealed, one can only assume that coverage features will be expanded going forward. Wait for it - but don't hold your breathe. Now, just another reason to return the Consumer Financial Protection Bureau to its original path. Trump has worked hard to gut that Bureau. Are you surprised?
Wayne (Pennsylvania)
As a long time educator, these healthcare programs used to be free to educators, who counted on healthcare as an important part of their salaries. After all, a healthy faculty is in the best interest of their students. Now these programs are anything but free, as teachers and staff pay an exorbitant amount on healthcare. It is also age based, and my take home pay has actually decreased every year for the last decade. To tax the healthcare insurance of public employees will denigrate the quality of healthcare, and make quality insurance unaffordable for school boards and teachers, leading to poor attendance by teachers, and a commensurate decrease in the quality of the education of our children. Let business executives pay this tax, and members of Congress, not our underpaid teachers.
Erica Smythe (Minnesota)
@Wayne Yes, but your party fought for this law in 2009. Your party spent every dime of political capital to make it law. I watched your union leadership up on that stage with Obama applauding ACA. What went wrong? Was it...reality?
Mathias (NORCAL)
@Erica Smythe Because they bowed their heads to the insurance companies.
Mathias (NORCAL)
@Wayne This has been true in the private sector as well. All wage gains are typically eaten or go lower than the increased medical costs. This is very true in unions that often negotiate to keep the medical but gain no wage gains because they are paying more. Or choose a plan where they have to pay in more when it used to be unseen. Medical costs are outrageous in the US. The younger generation has almost no access to health care so that’s why so many are progressive. Market actions have consequences. Representative Ocasio-Cortez Confronts Gilead CEO Over Truvada Pricing
bmck (Montreal)
As with most programs, government or otherwise, they undergo tweaks - and proponent to hindsight modifications does not necessarily make one a "foe."
@bmck Maybe so but the ACA is jam-packed with these types of provisions. There have been others that have been delayed and/or eliminated. Some were found to be unpalatable. Some were obviously impossible/difficult to implement even before the law was signed. Along with the "Cadillac Tax" the "Employer Mandate" also saw delays. What is particularly disturbing is not that these features were at the heart of the law but that they were integral to the "accounting" that demonstrated to cost of the law over time. I'm not sure if anyone has run the numbers but the ACA has got to be much more expensive than advertised.
bmck (Montreal)
@SJG Seems to me your comment is misplaced as it begs the question whether proponent(s) to modifications of original legislation make one a "foe."
PA Voter (Chester County,PA)
If the single-payer approach is too problematic, two other uncommon concepts need to be explored. First, what if a worker's health insurance could not be tied to their place of employment -- use a different affiliation? The other would be to tax the health benefits provided by employers and adjust the tax rates on individuals accordingly downward.
Michelle (Fremont)
@PA Voter If healthcare were not tied to employers, then everyone would be paying what individual buyers like me pay: A LOT more than what an employer sponsored plan costs (both what the employer and what the employee pay, combined) . That would actually force insurance companies to compete in the marketplace. But that seems to be the LAST thing ANY establishment politician wants.
Ana Luisa (Belgium)
@Michelle The exchanges installed by Obamacare actively increase competition among insurance companies. That's one of the reasons why the law has proven to curb premium increases.
Maggie (NYC)
@PA Voter Concur on count one. Having health insurance tied to employment is insane, for any number of reasons. Sever that tie and employees can move jobs without thinking about insurance; individuals can get the plan that works for their own situation. As a small employer, I hate that I have to make the decision about what plan to buy for our employees. It shouldn't be my decision.
HapinOregon (Southwest Corner of Oregon)
“You know, Paul, Reagan proves that deficits don’t matter. We won the mid-term elections. This is our due.” Former Vice-president Dick Cheney “Republicans care deeply about deficits, unless they’re caused by tax cuts. Then they don’t give a damn.” Norm Ornstein, American Enterprise Institute So now the Dems are drinking from the same fountain. I do hope something positive, aka Universal Health Care (including both insurance and treatment...), will be the result...
Gordon Jones (California)
@HapinOregon A sad commentary on the "Whack a Mole" syndrome. Best laid plans subject to work - arounds. This is a prime example. Hard to say this - I love free enterprise - it has been, for the most part - good for our Democratic Republic. But unfettered free enterprise keep raising its ugly head. Time to bite the bullet - universal medicare needs a close look. Our Democratic Republic has always been a work in progress.
Ken (New York)
Medicare does not now include dental or vision. Getting to Medicare for all will include a truly enormous investment. The answer is fixing the ACA as Biden has proposed to do. This will allow us to lower co-pays, deductibles and drug costs. While that is being done we can expand to make the system more single payor. But not at the expense of tens of millions of people being left without health care while we reach for a Medicare for All type system that does include private insurance options - just like all those countries that Socialists like to say have the best health care systems already do have - which is what the Sanders, Warren and whatever Harris' policy of the day offers. If the US just inserted no charge universal vaccination (HPV, MMR, Hepatitis, etc.) and prevention screening services - - or even public schools like was once done - free contraception and pre and post partum care for every woman in existing health care systems we would save so any trillions of dollars we wouldn't have to tax anyone for any of these services. We can't get science based health care education is our school systems. Does anyone really believe that MFA would be accomplished in less than two decades? Politicians know how to manipulate budget costs on paper - not deliver health care to women or our vets. How is MFA different than Mnuchin putting political pressure on Congress by saying we are running out of $$$ faster for SS faster than Republicans can distribute it to their donors?
tom harrison (seattle)
@Ken - If we simply end our war in Afghanistan, we could pay for Medicare For All and free college tuition.
Mathias (NORCAL)
@Ken I saw prices go up under the ACA. It is just that more people are covered.
Ken (New York)
@tom harrison That may be true although I doubt that advocates for MFA haven't already considered that. If so, why would Sanders, for example, say a tax increase would be required? Or Warren say that the money to pay for it would come from taxing corporations ? My point is that Medicare as it currently stands is expensive and lacking. Ask someone on a limited income that needs to lean on Medicaid as well just how convenient and useful the program is. My parents each pay $438.00 per month to make it even worth it. Most of that goes to Part D coverage, because drug prices would make it impossible to afford otherwise. And they still have to pay for any dental, vision, or uncovered service they need. And I have no interest in paying for college tuition for a kid whose parents bring in a million or so a year in income. So how much of all this reclaimed money from Afghanistan, and tax increases will also be demanded by people that call for open borders and providing health care for people that have entered the country illegally? We can't even come up with the money to provide care for our 9/11 first responders, nor care for our veterans. Yes, I blame Republicans for both of those things but you can't expect the voters of every state to care about either of those things. Or about controlling profiteering by corporations. Or to stop thinking that getting over on poor people is just good business. Or holding anyone accountable for lowering someone else's drug prices? They don't!
Cathy (Colorado)
I had breast cancer and luckily had excellent insurance that I paid for on my own. Obamacare wrecked that. My coverage went down and my costs went way up. My deductible was $1,000. Now it is $7,800. Finally found a plan that is somewhat decent and somewhat affordable. Now the House wants to mess with the ACA and the 5th circuit could strike down the entire thing. Can I tell you how sick I am of politicians messing with healthcare?
Cormac (NYC)
@Cathy Thank you for sharing that. I was a supporter of the ADA, and still am. I think it did way more good than harm in the aggregate, but it was very disruptive and there were people very inconvenienced and some made worse off by the shifts. Which is why I am not in favor of Medicare for All or any other proposal for wholesale sweeping change at this time. We made a big set of changes. Now we need to let them settle, take care of the people harmed in the transition, and make incremental improvements where it isn't working. People act as if this is ideological--like their is one healthcare Nirvana and we must reach it. But every change and disruption disrupts the real life and health of people right now. And we should be more careful about that. "First, do no harm."
Susan in Maine (Santa Fe)
@Cathy Wait a minute. Obamacare wrecked your insurance and now you are worried that the Supreme Court will strike down the ACA? Are you not aware that the ACA is Obamacare?
kz (Detroit)
The majority of the people voting on this understand neither "Obamacare" or the "Cadillac tax". "Party lines, fall in!"
Jerry Von Korff (St. Cloud Minnesota)
If they pass this fix without bulletproofing the law against the pending challenge to constitutionality, its legislative malpractice.
M (US)
Senate Majority Leader Mitch McConnell, President Trump, and Republicans in Congress must be laughing right now: they have the DEMOCRATS HELPING to destroy the Affordable Care Act for them. Are Democrats REALLY going to let Trump and GOP divide them? UNITED we stand.
dr. c.c. (planet earth)
When it comes to health care, everybody should have a cadillac--free. That would be single payer--a human right.
Cormac (NYC)
@dr. c.c. Wait, how is single payer the same as Cadillac for all? I mean, it could be, but you could also have single payer with really thin and inadequate coverage. Also, whether single payer or not, more bells and whistles--Cadillac coverage--cost more, so someone has to pay. Under single payer, we all pay together through our taxes rather than each of us pursuing our own arrangements. This brings the cost benefits (and inefficiencies) of scale, but it doesn't guarantee quality of care or completeness of coverage anymore than any other payment system. It makes sure the patient in one room and the patient in the next are getting equal benefits, not necessarily adequate ones.
Jp (Michigan)
@dr. c.c.:"When it comes to health care, everybody should have a cadillac--free." Free? Would you provide your services for free?
Cormac (NYC)
Ridiculous. They are making the one of the most egregiously false charges of the Republicans—that Democrats just give away “free stuff”—and making it true. If they want to do away with this tax, they should identify alternate funding source. And also alternate cost control measures to make up for removing the deterrent to escalating plan prices. (And while they are at it, they might want to do something to address the fact that they are removing a lot of the pressure on Labor to put more resources into raising wages and organizing more workers.) Courtney should be ashamed of himself.
@Cormac Yes. While not an essential feature of the law, The Cadillac Tax (along with other components that have been delayed or eliminated) was key to the "accounting" that demonstrated the costs of the law over time. A cynic might say that lawmakers new some of these features would be impossible to implement but only included them so that the projected costs appeared palatable.
Jbugko (Pittsburgh, pa)
During over a year's worth of haggling, Republicans - as it happens, IN BAD FAITH, added over 100 amendments to the initial plan. I wouldn't mind the initial plan that the GOP worked hard at scuttling, only to vote against the legislation anyway. If this had actually been "Obama"care I'd be using the public option and insurance companies would be bending over backwards to provide reasonable premiums. After all, something the Republicans did not destroy until a little later was the "Risk Corridor" provisoin that had given insurance companies an incentive to compete by providing them with their OWN insurance - that is, a fund that insured them a certain profit margin and in the event it dipped, the fund would cover it. Of course, the saboteurs not only removed all of the funds from that provision but also destablized the market-place. And don't you just love that they're suddenly not concerned about deficits, while Trump increases the deficit by over 1 trillion dollars EACH year?!?? Get these GOP influence-peddling dirtbags out of office - especially Kevin McCArthy and Mitch McConnell - they are enriching themselves while lying to as well as hurting the people they claim they represent. They shouldn't even get away with selling used cars.
J.D. (New Jersey)
168 billion over a decade sounds like absolute chump change these days.
Lilly (New Hampshire)
The ACA is a sweetheart deal from Obama and Biden for a managerial industry based on denying care as a financial tool, merely another extraction point of billions from the vanishing middle class.
Eamon (Canada)
In the following sentence the word held should be replaced with help for clarity And the White House has slashed funding to promote Obamacare sign-ups and for “navigators” who are supposed to held consumers enroll
Yeet (Squad)
I am just going to leave this here, I doubt many will watch, but primary source material is always better. The ACA will fail, the reason as its architect Mr. Gruber stated, is due to the stupidity of the American voter. Without the Cadillac tax this thing is toast.
Brendan (Seattle, WA)
What is Pelosi doing. First she attacks the liberal members of the party, now she's allowing a vote against Obamacare. People said she had political skill, but what is her game plan exactly? Dismantle Obamacare, but but also attack the Democratic politicians who are pushing for a viable replacement? I see no evidence of strategy or long term thinking here. Everything seems very reactionary and defensive.
Scot Stirling (Scottsdale)
Do they understand the importance of this tax to the justification for the ACA under the Constitution? The Supreme Court said it could not be justified under the Commerce Clause power, but it was upheld under the power of Congress to impose taxes. When all of the taxes go away, where is the power to pass this kind of legislation? This looks like the House is playing right into the Republicans' arguments for striking down the law entirely.
gking01 (Jackson Heights)
Even a tinsy bit or research will clarify who is fighting the Cadillac healthcare tax, and it isn't the rich guys at Goldman Sachs. They, I'm reasonably sure, don't like it but they shrug and pay it. It's the unions, and specifically the public union sector unions that have the Cadillac healthcare. One could likely throw in retired public university professors and administrators into that lot. When you pay nothing, more currently next to nothing, for your healthcare, it will constitute a Cadillac plan by any metric. If you get your healthcare and pension from the taxpayer -- be it as a retired director of the Colorado's Disability Council or professor emeritus at the Univ of Wisconsin or a twenty-year retiree of the NYFD -- you are doing *far* better than 85% of the folks in the private sector (except for the truly rich). Hence the term "Cadillac."
John (Woodbury, NJ)
The politics of this are terrible for Democrats in 2020. If this repeal passes, Trump will tweet "I'm signing a bill to repeal part of Obamacare and even Democrats agree that this law is a disgrace that must be repealed. Big bipartisan vote to repeal!" Then, in the election, he'll tell his base "I signed a bill to repeal a big part of Obamacare. We had to fight the Democrats very hard but got them to realize that this law is a disaster." In the debates, he'll say "I went to Chuck and Nancy and said 'You know, this part isn't working and to my surprise, they acted like real Americans and agreed to work with me for one of the only times.'" If he happens to be debating one of the sitting Senators who will need to vote on this bill, he'll either say "Why did you vote to repeal Obamacare if you think the law is so wonderful?" If the Senator did not vote for the bill, he'll say "Why did you vote against a provision that even so many Democrats agreed had to be done away with?" If this tax does not go into effect into 2022, why would Democrats want to bring this up now? Splitting with yourself is one of the worst things that you can do in politics. Get ready for an onslaught of Republican ads labeling any Democrat who voted for Obamacare and then voted for the repeal of this tax as a flip-flopper.
Frank F (Santa Monica, CA)
So now the Democrats in the House are prepared to do what have thus far failed to do: tank Obamacare. Naturally, the Republicans in the Senate are all for it! Without the Cadillac Tax to force employer-covered Americans onto the exchanges with the rest of us (so that you can feel our pain instead of accusing us of not having "shopped around" enough for lower premiums and better networks), "free"-market health care simply DOES NOT ADD UP. The risk pool is too small and too unhealthy. Just ask the guy who's payed 12K a year in insurance premiums for himself and his family, plus a 7K deductible, only to get dinged for $38K in "out-of-network" fees. And do you really think that once this tax goes away, employers will respond by paying ever-escalating premiums in order to keep their plans "generous"? Please. The beatings will continue unless and until we are all in the same (single-payer) boat.
RLW (Chicago)
There is no need for this tax provision if all Americans were covered by a single parrty health care provider where those earning minimum wage have the same coverage as Senate Republicans now do. i.e. Medicare for all paid for by a graduated income tax. "To each according to his needs, from each according to his means". I suppose Lindsay Graham would call me a Communist, but I always consider the source when being insulted.
Norman (NYC)
Sara Kliff of Vox went to Kentucky to find out why the people who gained most from Obamacare voted for Trump. They complained that the "Affordable" Care Act was too expensive. First they have to pay a premium, and then they have to pay a deductible of $1,500 before they get any benefits back. Union workers, who pay for their own health care as part of their compensation, don't want to be forced into that bad health care. Would you?
A. Axelrod (Hurricane, UT)
"The Economic Policy Institute, a liberal research group, argued ahead of the vote on Wednesday that health care costs are already decelerating, so the tax is unnecessary both to pay for the health law and to further slow down health cost increases." Huh? On what planet does the Institute see health care costs decelerating? I've been enrolled in the ACA from the start, and every year my premiums and deductibles have risen for the least expensive bronze plan. My wife and I currently pay a $1400/mo premium and each have separate $6500 deductibles. So if one of us needed care, we have to plunk down $23K/yr before they start paying anything. What a deal! Sorry, but I don't by this nonsense that health care costs are decelerating. Maybe if the dimwits in Congress had to pay what common citizens pay for insurance coverage, they might be more receptive to providing a workable health care system.
Joanne (Colorado)
Take a good look at Michael Bennet’s (and Tim Kaine’s) Medicare X plan—a phased plan to provide Medicare as a public option. Keep your employer insurance plan if you wish. Seems like a smart way to go.
Tamar (Nevada)
Obamacare was a disaster. It forced me to seek out concierge medical service because I could no longer find any doctors because the two internal medicine doctors that I had been seeing for over a decade bailed and became hospitalists (because of the law). Now I have to pay for concierge medicine annual fees, along with higher deductibles, increased premiums and higher copays. The ACA did nothing to help the healthcare system in this country. If you can keep your plan...(I couldn't) You'll keep your doctor (no, I didn't) You'll save $2,500 (no, I actually paid more than double that)
Steven Sullivan (nyc)
You're aware that for others, the ACA has been a lifesaver, right?
Lorenzo (New York)
@Steven Sullivan it may have been a lifesaver but Tamar and a zillion people like him paid for it.
Martha Shelley (Portland, OR)
When the ACA was written, single payer and public option were taken off the table. Physicians who came to Congress to advocate for single payer were arrested. As a result, the ACA was a giveaway to the insurance and pharmaceutical companies. 30% of health care dollars go to insurers who provide no care--they profit by denying care. We've all read stories about the insane cost of drugs in this country, but under the law, the government isn't allowed to negotiate with the drug companies. All the proposed tinkering with the ACA won't solve the problem, which is insane corporate greed, and legislators who are in the corporations' pockets.
Frank (Raleigh, NC)
Get more medical cae than they Need? What??? You give this as a reason for the tax on "generous employer sponsored health plans." I dare you to give me any good examples of how someone would do that. The" logic" is absurd. Like many here note, our entire system is absurd, far more expensive than other countries per person, (per capita) health care costs. Corporations get tax breaks for their employer plans as it it, costing the rest of us more taxes. A time writer here today, (Tom Friedman) asks why anyone would want to get rid of private insurers which of course include employer plans for employees. Why? First of all they are for profit companies and they have investors they must pay. Billions of dollars goes to the insurance company profit and the investors, thereby increasing the entire costs in the system. Absolute madness. The inefficiency this causes is also massive and costs billions. If everyone goes on a national, single payer plan, we get a huge, massive sized insurance pool; far massive than any private pool, current medicare pool, or employer pool. That is the a major, major policy principle for any insurance: home, auto, whatever. Giant advantages exist for going to the national plan; lower payments for everyone, more efficiency, simplicity. Capitalism does not work for critical items like health care. Biden is lying about the Sanders plan. The dem "debates" on MSNBC asked ignorant questions. It is not more costly; it is cheaper. Read! And Learn!
Casual Observer (Los Angeles)
Cadillac health coverage is not a constructive slogan, it implies that the health care provided is excessive, beyond what is necessary to serve the basic needs of people. Well in fact, that coverage should be the minimum standard for everyone. Even the coverage under the ACA is inferior to very many plans offered through people's employment, and is better than that offered to retired people through Medicare. To achieve the most efficient kind of coverage is going to take a lot of change to how we cover the costs of health care. We will in the end have to offer good care at affordable prices but getting there will not be easy nor quick. The Medicare for all plan is fundamentally misguided. It simply dismisses all the problems that must be addressed to achieve universal care which is affordable. In fact, it's hype and is not a solution. The first rational step is to firm up the ACA and to introduce a public option. Then as employers decide to opt out of providing health care as benefit, move people into the ACA. Introduce a common claims system and common care coding system. From there, introduce a common overarching risk management system to protect all insurers from ruinous outcomes. From there, single payer with insurers who wish to participate as assigned insurers under an overarching assignment system. Slow is smooth and smooth is fast.
From Where I Sit (Gotham)
Coverage that exceeds what you can afford IS a Cadillac plan.
Casual Observer (Los Angeles)
@From Where I Sit But you can afford to pay taxes on top of that?
James (Phoenix)
I'd hardly call them "unlikely" foes. Many predicted that this provision wouldn't survive for just this reason. Including an unpopular provision in a law that doesn't take effect for years is common. It allows the bill's proponents to argue it is revenue-neutral without having to incur any real pain. Then, after the bill becomes law, Congress starts stripping out all of the fiscally-prudent, but politically-unpopular, provisions so as not to anger their base. Rest assured--both major parties do this all the time. Neither party wants to confront these hard choices (e.g., "the tax cuts will pay for themselves!). So continue enjoying our free lunch now until the debt crashes our economy.
DKM (NE Ohio)
One gets rid of "Cadillac" health plans by instituting a true Universal Health Care plan. One pays for it by taxing ALL citizens appropriately, and proportionately to one's income: you earn more, you pay more. One also pays for it by taxing ALL corporations appropriately, and if they do not like it, they can indeed go somewhere else, take their families, lose their citizenship(s), and pay appropriate taxes to whatever country they then reside in. Put another way: if you're an American Corporation, you pay American taxes, and you employ American citizens, first and foremost. And finally, with everyone feeling comfortable knowing the Doctor is always in (her/his) house, ready to treat whatever ails one (within limits), and with incomes all at true livable wages, all around...we then all pay a bit more in Federal taxes because all that fine health care is free: meaning we all pay for it, as we should. Rather simple. At least, it is simple if we decide to cut out all the means and methods that far too many use to enrich themselves at the expense of the rest of us. Well, one can hope for some reason and sanity, can't one?
Mor (California)
@DKM for every complex problem, there is one solution that is simple, easy and wrong. I lived in several countries with universal healthcare, including Italy and Israel. While both are superior to the jury-rigged American system, they bear no resemblance to the picture you paint. Who decides what “within limits” means? Clearly the government. And what if your necessary treatment lies outside these limits? Well, this is why we need supplementary private insurance which Medicare for All would outlaw. I am not even talking about the fact that if Amazon, Apple and Google relocate to China tomorrow, the US will be hit by such a recession that people will be clamoring for bread, not medicines. Yours is a perfect example of left-wing populism trying very hard to be as mindless as it’s right-wing counterpart. Well, Trump is still doing the mindlessness thing better but I’m afraid, not for long.
HJB (New York)
How about a clear chart that shows: 1) who will benefit from cutting the Cadillac tax, and 2) who will be paying the costs that result from that cut.
NDJ (Arizona)
I have health insurance through my employer. Supposed to be one of the best employers for benefits. I have never before had such terrible health Insurance coverage. There are large put-of-pocket fees. Getting an appointment with a physician, whether a general internist or a specialist, takes months. There are no acute appointments- only the urgent care is available, and the staff is sub-skilled. The generic medications prescribed are clearly manufactured at the cheapest facilities-ie, can’t even cut a pill in half without it crumbling. And that is my description of my fabulous private healthcare insurance.
tom harrison (seattle)
@NDJ - I have Medicare and have not yet had a co-pay or deductible or anything. I just to to the doctor and get help. My health has dramatically improved since getting it.
Frank F (Santa Monica, CA)
@NDJ Sounds like exactly what Covered California (one of the most-vaunted ACA "successes") wants me to pay 12K per year in premiums for.
Richard (California)
I think this is revealing a somewhat fatal flaw in the ACA - it doesn't actually do anything to reduce medical costs. High deductible health plans have become increasingly popular, but when you're paying 100% of your health care costs are you really insured? Especially considering that most of the people gravitating towards low cost plans don't have extra money to put aside into a HSA. Competition between insurance companies is meaningless when a hospital tells people it doesn't accept the low price insurance companies. So consumers who actually want good insurance need to go to these higher cost plans, and that's what employers are going to offer to attract talent. The only way to fix health care in this country is to get a giant player, aka the government, into the ring setting prices and fixing the market.
JerseyGirl (Princeton NJ)
@Richard How does the government set prices? You mean, tell doctors and hospitals what they have to accept for their services? Nobody "sets prices.' What they do is either negotiate prices via being a major payer or else run their own system (eg Kaiser, the NHS in the UK -- remember the royals who have babies coming out of the "non-NHS" wing of the hospital?). The government does the former with Medicare and Medicaid and the later with the VA. But I agree that Obamacare never dealt with the real elephant in the room -- what doctors and hospitals get paid in the US (far more than anyone else in the world)
Richard (New York)
@Richard Actually setting prices destroys any market.
Jbugko (Pittsburgh, pa)
@Richard It did make the marketplace more competitive and encouraged insurance companies to compete by guaranteeing them compensation if they went to low and did not succeed in getting a 15% gain. But Republicans defunded the Risk Corridor provision. The Republican party - while claiming they are proponents of a competitive markeplace - actually destabilized the marketplace and once they took that money out and obliterated the risk corridor provision, insurance companies increased not only their premiums, but their deductibles. Don't complain about what actually would have been "Obamacare" if Republicans hadn't systematically dismantled it.
Ockham9 (Norman, OK)
The bill’s title, “Middle Class Health Benefits Tax Repeal Act,” should be amended to read more accurately “Privileged Segments of the Middle Class (and High-Paid Corporate Executives) Health Benefits Tax Repeal Act.” I’d support this if in the next vote Congress approved a universal health care bill that controlled the cost of hospitalization, medical procedures and pharmaceuticals and severely regulated the insurance industry. But of course that’s a bridge too far.
Ellen (Berkeley)
Just fix the law. We could have a reasonable public option in this country if only our so-called leaders would do the responsible thing and work towards solutions regarding healthcare rather than endless posturing. The ACA was a start, but everyone knew at the time it would need to be modified and improved upon. Why is that this country still can't get it together to offer healthcare to its citizens. Every other western nation does. Why? Because it makes both good economic sense and it strengthens our society in the long run. Medicare works and includes private supplemental plans....why not expand that for everyone? Instead of worrying about giving tax cuts to the uber-wealthy, let's focus on every day Americans for once eh?
Ellen (San Diego)
@Ellen Unfortunately, most of our “leaders” - on both sides of the aisle- are beholden to corporate donors, big time. Check out Open Secrets to see how much most of them rake in from the likes of Big Pharma or Big Health Insurance. This is why they obfuscate and do little- to- nothing for us on this and so many other matters.
Owen Ap Owen (California)
Obamacare, despite providing a benefit to millions of people, myself included, is a convoluted, over-complex muddle of a program. It's two immense flaws are that it does not provide simple consistent coverage to everyone and that it does absolutely nothing to constrain the skyrocketing cost of every aspect of health care in America. This is because, in order to be politically palatable, Obamacare still funnels everything through private insurance companies who take a giant share of medical spending in return for providing absolutely no medical benefit. And to get the medical industry on board it basically had to take cost controls off the table. Now, the cracks in the edifice of Obamacare are growing and it's unsustainable as written. We can do much better if only we could get past the selfishness of those who feel that they are personally secure as well as the greed driven corporate opposition.
Robert (Out west)
Sigh. It is simple nonsense to claim that Obamacare doesn’t have any cost controls built in, especially when you’re responding to an article that discusses the Cad tax as a cost control.
Erica Smythe (Minnesota)
@Owen Ap Owen You want to lower the cost of healthcare? You have to pay the freight. If you drink and drive quite frequently and get DWI's..State Farm isn't going to sell you car insurance for the same rate as teetotaler. Conversely, if you keep eating pizza's and taco's and being a lounge lizard, why should you pay the same premium as I when I take care of my health and eat well? Moral hazard. The moment they take this out of the price of's no longer insurance. IT's a giveaway. If the nation lost 20% of our BMI, our healthcare costs as a nation would reduce by 20% without changing a thing..and we'd have more than enough capacity to deal proactively with people who have ailments/illnesses through no fault of their own. But to talk about moral hazard with a Democrat is like talking about hamburgers to a vegan. They just don't get.
Owen Ap Owen (California)
@Robert Things like the so-called Cadillac Tax were tiny bandaids on the rampaging stream of endless medical cost increases especially in prescription drugs. Besides the Cadillac Tax never even took effect. How can you claim it as a cost control when it's implementation was delayed to 2022 and now is likely to be cancelled altogether?
Mark (Las Vegas)
Eliminating a tax doesn't in itself create a budget deficit. The problem is Obamacare. The whole law needs to go to end the deficit. It likely will as it continues to collapse of its own weight.
Erica Smythe (Minnesota)
@Mark It wasn't a tax because the Democrats voted to kick the tax down the road the second they voted for it. How come nobody ever questioned why Al Franken and Amy Klobuchar voted for the Medical Device (which cost Minnesota over 20,000 medtech jobs) and then turned around the next day and fought to rescind the Medical Device tax? Someone's got some answers to provide..and sadly..the American Media is either too scared to ask..or to in bed with Progressives to care.
Urs (Reno, NV)
It's amazing how we get to pay taxes for the Trump Family Empire but we can't afford a plan that keeps the cost of healthcare down because Republicans have run the federal deficit into the ground.
Linda (Sausalito, CA)
It may be the time for Democrats to ratchet it up to an extreme position: The United States is the only so-called civilized nation that does not have universal healthcare. Dumb down the message, Lather, Rinse, Repeat! Right now we are the laughing stock of the world. Basic healthcare should be a right, not a privilege. There is no reason we can't spread the risk over the entire population, and 11 million "illegals" will not even change the economics. They pay plenty of taxes. The US can have a public insurance plan and private plans that are separate from the basic plan that will drive our healthcare costs down. Right now England is struggling with dementia and an aging population, so they must refine taxation and how the NHS handles this. All countries are managing the global aging population issue, but not squabbling about the moral obligation of caring for their citizens.
Sarah99 (Richmond)
Another gift to the Unions from the Democrats, paid for by middle class Americans who will never see this benefit. And Democrats want to know why working America does not support them anymore? Geez. Can't wait to see how the Unions with the platinum-plated benefits are going to fight Single Payer. Cadillac Plans will be a relic under Single Payer. Just get in line and wait your turn, the doctor will be with you in a few months! LOL.
Matt (Southern CA)
@Sarah99 I doubt you made the same argument when the Republicans massively cut taxes on foreign entities in 2017.
Steven Sullivan (nyc)
it's odd that you think unions and middle class are antithetical. Unions are what launched generations of families into the middle class.
G (Edison, NJ)
C'mon, guys, let's get real. No one, least of all Obama, ever believed this tax would really kick in. That's why they had it start so many years later than the rest of Obamacare. This way, they could claim that Obamacare wouldn't cost so much, and (wink, wink), they would be able to act like responsible adults, with a firm belief that their union allies would eventually kill it. Score one more for cynicism.
Roland Berger (Magog, Québec, Canada)
So Democrats will join Republicans and unions in get back things as they were. Why impeaching Trump?
cruciform (new york city)
Social contract? We don't need no stinkin' social contract.
Alan MacDonald (Wells, Maine)
ObamaCare is not as bad a faux/no-solution and scam as Bush’s MediCare Part D drugged ‘doughnut-hole’ in-coverage, but like any medical care scheme that involves private for-profit corporations within this Disguised Global Crony Capitalist Empire, I have no use for, and am entirely against all such ‘negative externality cost dumping’ con-jobs and Ponzi schemes.
Doug Karo (Durham, NH)
I can imagine those privileged enough to be rather insulated from medical costs because of expansive health insurance policies (often paid for by someone else) would ignore their effect on supporting higher and higher medical costs for everyone else. I expect that privileged group includes House Democrats and some of their financial supporters too. I expect that finally applying the tax would be a good thing on balance.
Norman (NYC)
@Doug Karo If you read the story more carefully you'll see that most of those insured are union workers in skilled trades who have negotiated all-inclusive health care plans as part of their compensation package. They earned it themselves. Their negotiations with their employer has nothing to do with you. What you're trying to do is tax them more on their own income, because they were smart enough to figure out that a $1,500 premium plus a $1,500 deductible is $3,000.
C Wolfe (Bloomington IN)
Lee and Bivens wrote: "The tax aims to reduce patients’ utilization of health care. But the glaring problem of U.S. health costs is not excess utilization; instead it is high and rising prices for health care.” Precisely. If I spend all my money paying premiums or the "Cadillac" tax and still have a significant deductible, I might avoid the early care I need that might actually hold down the total cost of my treatment. I do know people who, in my mother's words, "run to the doctor all the time." But they are few in number, and there is actually something wrong with such people; it's just that it's a mental health issue. The fallacy of treating health care like a consumer good is that nobody chooses to get sick and "consume" health care the way they choose to go out and splurge on a new wardrobe. Making people pay till it hurts now in the mere hope of being taken care of later when they do need it is asking them to choose between different ills. It's absurd.
Norman (NYC)
@C Wolfe You are correct. In the 1970s, the Rand Health Insurance Experiment randomized patients into different groups with different copays, to see whether patients would "choose health care more wisely" with "skin in the game." The result: They made bad choices which harmed their health. They stopped cost-efficient, life-saving preventive measures like medication for blood pressure, for asthma control, and mammograms for older women in the highest risk group. Impose a co-payment of $15, and the mammogram rate goes down by 10%. The Rand study has been repeated ever since the 1970s, and their conclusions have been confirmed repeatedly, and published in medical journals like NEJM and JAMA: Deductibles and co-payments result in worse health care. In one study of IBM employees, patients with asthma were more likely to skip their controller medication, wind up in the emergency room, and the ER costs wiped out any savings in the entire program. The free market doesn't work in health care. It doesn't produce better health care and it doesn't even save money. Milton Friedman is dead. Let's drive a stake through his heart.
ConA (Philly,PA)
@Norman Thank you for this excellent summary. My GP charges $50 copay-I haven't been there for years. And forget about getting a test with my 7K deductible.
Neil Grossman (Lake Hiawatha, NJ)
This article makes me focus on the fact that our country has not decided whether we want health care to be affordable or whether we want it instead to be free and unlimited. There is quite a difference. How can a solution be reached until we know which it is that we want?
DKM (NE Ohio)
@Neil Grossman Health care cannot be affordable ever if it is to be free *and*unlimited*. That is the problem, and it is the very problem that was confronted when Democrats were trying to work out a fair quasi-universal health care system under President Obama. Health care should be free. It should not be unlimited. As to affordability, though, taxation will (should) cover that issue in the sense that all will pay in proportion to one's income, which is fair. What Fed Gov must do is demand that health care be affordable, which means caps, restrictions, and all those other nasty little words that so many Corporate Entities, not to mention Shareholders, hate to hear. So, health care will be affordable only when we all realize that it is not free, and it is not unlimited.
Tom Meadowcroft (New Jersey)
Cadillac plans are negotiated by old union members (who generally run the locals) at the expense of young ones, who will not use them; preferences for seniority are part of what make unions unpopular with young Americans. Cadillac plans contribute to the excessive spending on health care in this country. They are very much a part of the problem, and what we need to move away from as we reform the health care industry. They would certainly disappear in a single payer system. Doing away with the Cadillac tax is a handout from the Democratic party to their paymasters in the big unions. It's a step backwards for Obamacare, and a step backwards for the Democratic party, who need to step out of the shadow of big public unions and work for all Americans.
Ellen (San Diego)
@Tom Meadowcroft Both parties are in the shadow of corporations and the 1%. Why single out unions, the only entities standing that fight for decent wages and benefits for their workers?
Louise (CT)
@Tom Meadowcroft: On what data do you base your assumption that younger union members "will not use" their plans? Younger union members don't have children with debilitating special needs? Younger union members and their family members don't get cancer? Younger union members don't suffer catastrophic injuries in vehicle accidents? Younger union members don't have complex pre-existing conditions? Have you ever represented union members at the bargaining table, and listened to what your members want when preparing for that?
Tom Meadowcroft (New Jersey)
@Louise I've been in and dealt with plenty of unions. I'm also old enough to know that people under 40 have insignificant health care costs relative to those over 50. A tiny fraction of children and young people have any health care problems. I've seen too many unions sacrifice wage gains for their younger workers so the union leaders, usually in their last 10 years before retirement, can feather-bed their health care plans and pensions.
Tom (Calgary)
I'm a Canadian who quite willingly pays into my national and provincial health care systems. While I agree with Sanders, Harris, Warren that Americans should have a single-payer system, I still haven't heard them address how they would make the transition to such a system. And so, they open their very normal idea about health care to reactions like those Obama killing granny with his death panels. Why are there no clear descriptions from the Dems proposing such a change for how they would bring about? Get to work and then to the megaphone please Bernie, Elizabeth and Kamala.
@Tom Check out Elizabeth Warren’s campaign website, she has a plan. It involves shoring up Obamacare and adding a public option, with Medicare for All as a long term goal.
Jade East (Yellow Springs)
@Tom ...and Nancy.
steve (CT)
@Jade East “Businesses would save over $9,000 in health care costs for the average employee under this option In 2016, employers paid an average of $12,865 in private health insurance premiums for a worker with a family of four who makes $50,000 a year. Under this option, employers would pay a 7.5 percent payroll tax to help finance Medicare for All – just $3,750 – a savings of more than $9,000 a year for that employee.” “During the four-year transition period to guarantee health care as a right, millions of workers will have the option to transfer from their employer-provided health care to the new Medicare for All system. As workers shift into the new system, employers will be required to pay either 75 percent of what they are currently paying for health care costs for each of their employees who enroll in Medicare for All, or the 7.5 percent payroll tax, whichever is higher.” “An employer’s first $2 million in payroll would be exempt from this premium protecting small businesses throughout the country. “
Wenga (US)
I can't speak to the macro level economics of the tax but the affect on employer plans and middle class workers is real. Employers used it as air cover to ratchet up deductibles, reduce choice, and cut back coverage--the result is a real and substantial hit to the pocketbook of many.
Dan (IL)
@Wenga if you are non-union salaried worker, what says that your company wouldn't increase deductible, reduce choice and cut back coverage under whatever pretext - tax or no tax? It's not like you have a sit at the bargaining table today!
What hypocrisy from Democrats in Congress. The rest of us who get NO benefit from these gold plated medical insurance plans that cost $30,000 or more for a family and we who will never qualify for them will continue to pay for them with our tax dollars and increased federal deficits. More welfare for the privileged ! Why doesn't this article contain a very useful list of which Democratic Presidential candidates support this elite tax benefit and which don't. We need to know.
Erica Smythe (Minnesota)
@AH2 What you really mean is welfare for the union members. There..fixed it for you. I get that you're angry with teachers, cops, firefighters, longshoreman, plumbers, electricians, cab drivers, NFL players, female soccer players, and pilots. I'd be mad too. The only reason ACA was allowed to come to the floor for a vote was because the CBO scored it with this 40% tax in place. The next day (or so it seems) the Democrats voted to shelve the 40% tax. Where I come from that's called 3 card monte. And it's illegal.
Norman (NYC)
@AH2 The beneficiaries of these "Cadillac plans" are mostly union members in skilled trades who negotiated good health plans (similar to Canadian health care) as part of their compensation. You don't pay any part of it. If you wanted the same insurance, you should have joined a union and negotiated for it. Or you should have demanded that your legislators gave you the same health plan the Canadians and British enjoy.
Peter (New York)
@AH2 You are very mistaken about what is a Cadillac health care plan. It is a "luxury" health care plan provided by employers. Hence, you may never qualify for one or pay for it because you don't work for a firm that has one. Employers and Unions don't like the tax because it is rather expensive which is why they want it repealed. Part of it's intention was to help pay for Obamacare. Ref:
steve (CT)
Another reason why Democrats in the House should be voting on Medicare for All - now. This will show the people who stands with the voters who support Medicare for All supported by over 60%, and who stands with the Insurance Corporations and Wall Street. Instead of employers taking money out of your paycheck it would just be a part of your taxes at a large savings estimated at over $5 trillion over 10 years. It would also provide health care not just insurance that only a some are able to afford now.
Bruce Kirschenbaum (Raleigh)
@steve Medicare for all is a long range plan. Cannot be done in 4 years as Sanders claims (BTW, he has not accomplished very much in all his years in Senate. All of sudden he is champion of everyone). I am on Medicare. It is not free. People don't understand that. Non medicare people think we get it all for free. Far from it. We pay a few to several hundred dollars per month. Can't people look at details?
steve (CT)
@Bruce Kirschenbaum Should maybe firefighters responding to your 911 call say it is a long range plan to put your fire out - first do you have your insurance plan number- it is socialism to think we should be able to put all people fires out - too expensive. If we put a man on the moon we can plan for a 4 year transition to Medicare for All. Are you saying America is not great or capable? Where did I say it was free - I said it would be part of your taxes.
Cormac (NYC)
@steve This episode shows precisely why “Medicare for all” is not a serious proposal. It would require all these folks who have “Cadillac plans” now to forfeit them in return for the less generous and less tailored benefits of the Medicare program. Do you think they will be happy about it? Do you think Members of Congress, who won’t even let this tax go forward, are going to vote to force those people to trade their plans for Medicare? The push they got on this was the political equivalent of a truck backfiring and the House is ready to fold like the proverbial law chair; how do you think they will respond under the heavy artillery that will face attempts to eliminate all private insurance plans?
Nick Metrowsky (Longmont CO)
“Smart cost containment policy should address these prices, not seek to ratchet down how much care patients seek.” It si about time that this repeal idea was being repealed. If the idea of this was to lower health care costs, then that should have been part of the ACA; that is getting the greed taken away from insurance companies, drug companies, pharmacy middle men, for prof it hospitals and greedy doctors. That should have been teh cost containment, not hitting people with a tax, because they had better than bronze coverage. Now, let's fix the ACA. Let's add cost containment. Let's get rid of out of network. Let's create insurance coverage that si national in scope, creating the largest possible groups to spread risk. Let's add the public option. Let every American who wants to get insurance the same way Federal Employees and Congress does, from here: Then we Americans can have the same insurance that Congress has.
Bruce Kirschenbaum (Raleigh)
@Nick Metrowsky Again, learn the facts. Members of Congress have to get their health care thorough ACA and most go through the District's exchange. They do get anything different. Unless they want to pay completely privately.
Nick Metrowsky (Longmont CO)
@Bruce Kirschenbaum Only their staffs; Members of Congress get federal government heath care coverage.
Jade East (Yellow Springs)
@Bruce Kirschenbaum Did congress lose their previous healthcare coverage when the ACA was passed?
John Hanzel (Glenview)
Ideally this will be irrelevant by 2022. Changes in plans and increases in deductibles were happening before the ACA, and while I haven't seen studies about this I would think the increase in the cost of the employer provided plans have been a factor in the stagnation of wages. Bottom lines are bottom lines.
Auntie Mame (NYC)
@John Hanzel Stagnation in wages-- international market place where products are produced abroad and labor costs are much less than in the USA. BTW why is inflation or for that matter longevity *years on the job) any reason to raise wages? How is that capitalist?
David Folts (Girard , Ohio)
Instead of just repealing it, why are Democrats not seeking some type of concession from Republicans for getting rid of this part of the A.C.A.?
Matt (Southern CA)
@David Folts Doing so would be politically disastrous. Can you imagine the attack ads? “Democrats demanded concessions to cut your taxes!” To CUT your taxes!” In a more egalitarian era, that wouldn’t necessarily be a death sentence. But we’re more than happy to rack up a credit card bill that won’t be paid until after many of us are dead.
Casey (New York, NY)
Health care is a utility. We need to regulate it if private and provide a public option. Capitalism does not work at all for Health Insurqnce
Elizabeth (Minnesota)
@Casey Yes, I agree. Regulate it and cost control it. It is so obvious it makes me want to scream.
Len Charlap (Princeton NJ)
@Casey - Public utilities have not had a good record advancing the cause of clean energy, let alone preventing fires. Would you prefer private fire departments if they were regulated and controlled? More to the point Switzerland has just such a system as you propose. Look at this: Here are the per capita figures for health care costs in 2016 in PPP dollars: US - 9507.2 Austria - 5227.3 Belgium - 4839.8 France - 4500.4 Germany - 5550.6 Luxembourg - 7462.8 The Netherlands - 5385.4 Switzerland - 7919.0 (strongly regulated private companies) Sweden - 5487.5 Denmark - 5199.3 UK - 4192.5 Canada - 4643.7 (Medicare for All) OECD Average - 4003 With the exception of the Netherlands (which has a dual system) all the other countries have a universal, government run system such as Medicare for All.
Cormac (NYC)
@Casey Wait, if it is private and regulated, how is that not capitalism? In the words of Inigo Montoya: "You keep using that word; I do not think it means what you think it means."
Mark (Cheyenne WY)
Relax folks. This is part of adjusting a complex policy, as opposed to the GOPs efforts to kill it outright.
Ernest Montague (Oakland, CA)
@Mark . LOL. It's a massive gift to unions and the wealthy, at the expense of the middle class. And one more nail in the coffin of the US and its runaway deficit and debt load.
Steven Sullivan (nyc)
Union members getting 'cadillac' coverage *are* part of the middle class.
Amoret (North Dakota)
@Ernest Montague These 'cadillac' plans are ones that I had at several middle, and some lower class jobs - no union in sight.
See also