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“The Cadillac tax”

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Possible ACA compromises


Henry J. Aaron, of the Brookings Institution, in a MedPage Today article, looks at the following areas of  revision and possible compromise as the Republican-controlled Congress battles the Affordable Care Act:


Medical Device Tax

“Its repeal would not alter the structure of health reform in any important way. For that reason, supporters of Obamacare can afford to ‘lose’ on this provision.”

The Employer Mandate

”Studies indicate that even if the mandate were dropped, few employers would actually stop offering insurance.”

 Small Business Exchange

“Even in Massachusetts, where a health reform much like Obamacare was enacted in 2006, few businesses have bothered with that state’s small-business exchange. Not much would change if the small-business exchanges were scrapped.”

”The Cadillac Tax”

This levy is the ACA excise tax on high-cost health plans meant to slow healthcare costs and finance ┬ácoverage expansion. “Many Republicans {Mr. Aaron writes} believe that the current tax is too weak, too slow to take effect, and not well designed, and some Democrats agree with them. Were Republicans to insist on strengthening, accelerating, and redesigning the Cadillac tax, some Democrats might support them.”

Independent Payment Advisory Board

”Republicans — and some Democrats — have been calling for doing away with the Independent Payment Advisory Board (IPAB).

”….Repealing IPAB would grant its critics a victory and, at least in the near term, would cost Obamacare supporters little.”

“The Family Glitch”

”The most important single change that supporters of Obamacare would seek is correction of a flaw known as the ‘family glitch.’Low and moderate income families are eligible for tax credits to help them buy health insurance through health exchanges but not if their employers offer them ‘affordable’ health insurance coverage.”




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