• ACA taxes on insurers

    Not exactly a health policy emergency, I know, but I’m breaking my vow of silence to insert some clarification into discussions of taxes on insurers to be imposed under the ACA. There are two different taxes, as explained by Jamie Downey:

    [1] Starting in 2014, the health insurance industry will be subject to an $8.0 billion annual excise tax. The excise tax increases to $11.3 billion annually for 2015, 2016, and 2017. The excise tax increases to $14.3 billion in 2018 and rises by inflation thereafter. The tax is assessed based on a companies market share and is non-deductible for federal tax purposes. […]

    [2] Starting in 2018, high cost health insurance plans will be subject to a tax. Plans for single persons that cost in excess of $10,200 and family plans that cost in excess of $27,500 are in this sections crosshairs. The excise tax rate on incremental costs will be 40 percent. In an attempt to appease union dissent, this tax will not be assessed on the individual but will be assessed on the insurance company providing the plan.

    Notice that both taxes are of the excise type, levied on insurers. But nobody expects insurers to eat the tax. They’ll pass it along to businesses and consumers, you and me.

    Notice also that it’s the second tax–the excise or “Cadillac” tax on high-premium plans–that has received the bulk of attention. It begins in 2018. Not mentioned above, the premium thresholds that trigger the Cadillac tax are indexed to inflation (overall inflation, not medical inflation).

    But the first tax begins sooner, in 2014. And it’s that one that the insurance industry is targeting for removal right now.

    • The 3.8% tax on excess capital gains has been making the rounds with claims that it is a tax on all real estate.


    • I know economists claim taxes like these are passed on to consumers, but with the new limits on medical loss expenses, it will be quite difficult to do that, unless excises taxes are included as medical expenses (not likely)

      • @Kevin Outterson – It’s a good point. It only applies when the MLR minimum is binding. Given how politics works, I’m sure there are many plans for which it won’t be. That’s plausible for the 2014 tax (and that tax becomes smaller as a proportion of health costs since it is indexed to general inflation).

        However, this strikes me as a massive issue for the Cadillac tax, which grows over time since the thresholds are indexed to general inflation. I think there’s going to be a problem preventing that from passing through. If that regulation really sticks (and I can’t imagine it), then it’s certain to cause dramatic change in health care. I seriously can’t imagine this working out that way. Can you?