I have a pretty good health care plan that costs about $12,000 per year

[scheming daemons]

$6,000 paid by me... $6,000 paid by my employer.


It's pretty decent coverage and it is for my whole family.



My reading of the Senate bill says that the "Cadillac tax" is for plans that cost more than $23,000 per year.


I would venture to bet that 99% of DU is paying far less than $23,000 per year on their health care premiums.


I know lots of union folks (my Dad is one)... and their health plans are nowhere near $23,000 per year.


So.... I don't get it. What am I missing here? I've read and re-read the provision in the Senate bill and it indicates that hardly ANYONE in the middle class - even union workers with real good health care plans - will be paying this tax.


Chime in if your premiums are more than $23,000 per year to cover your family. I'd like to know what the hell you get for that kind of premium level. Daily Swedish massages?

I think this is much wailing about something that won't impact anybody but the very well off.

[saracat]

1. I dunno . Mine is close and we have a $5000 deductable

and they are raising us yet again. We have Blue Cross and we certainly don't have a "cadillac". If we could lower the deductable, I am sure we would be at $23, 000!

[LiberalAndProud]

2. The excise tax is actually one of those progressive taxes

that we on the left are supposed to favor. But you won't be able to convince the anti-insurance folks on that.

http://www.whitehouse.gov/blog/2009/12/16/truth-health-care-reform-and-taxes

[laughingliberal]

11. I favor the progressive tax the House imposes on those making over $500,000 per year

that we on the left favor a lot more! But you won't be able to convince the screw the middle class folks on that.

[FormerDittoHead]

32. I like progessive taxes, but I don't think that $70k'ers are in the 'bracket' as $500k'ers...

That's my only problem.

I'm ALL FOR $70k'ers paying higher rates than $30k'ers, but it's NOT progressive when $500k'ers are paying the same rate as $70k'ers.

[Double T]

3. The biggest problem is that a family health care plan costs $12,000.00/year............

for substandard care. The current health care legislation does NOTHING to bring down the excessive costs of wall street's controlled American health care plans.

[Hekate]

4. I want me some daily Swedish massages! Probably won't get any, because our plan is about what yours

... is, as to cost. All this wailing and gnashing of teeth had me bracing myself for a new tax, so thanks for the clarification. The people I know who complain about their insurance costs (including Mr. H and me) -- none of them are chipping in for premiums of $23K/yr.

Hekate

[laughingliberal]

12. The premium level that is taxed for individuals in $8500 per year

I was paying that for my husband's coverage in 2004 and it was no gold plated plan.

[salin]

31. Interesting..... I believe that basic care (not catastrophic) in my area is about 7200 a year

for an individual. Guessing a lot of folks will be hit. Sounds scary - but only the amount over is taxed - so if one had a 8600 per year - only the $100 is taxable. I can afford that - if the tradeoff is more insured, contained costs, and ending the fear that each time I go to a doctor something is going to be found that in the future will deny me insurance coverage per a 'preexisting condition.'

[truedelphi]

5. From what I have heard, initially it won't affect more than a small group of

People. But at the four or five year mark, the excise tax will be expanded. And then it will affect more people.

Also if your source is the WH, I don't know how much trust I have in what they would tell me.

The Bill is currently over 10,000 pages long - so how the hell can we know? If our paid reps in Congress with all their aides and advisers don't know, how can we?

[scheming daemons]

6. My source is the text of the Senate bill

Who knows what the final bill will look like....


....but that's what it says now... If I'm reading it correctly.

[truedelphi]

7. There is this discussion from the American Underwriters

website --

However, as noted by America’s Health Insurance Plans, a new $70 billion premium tax will be instituted between 2011 and 2019 “that will increase the cost of health care coverage for millions of Americans and fall primarily on small businesses and those who purchase coverage in the individual market.”

Specifically, according to Washington Analysis, as changed by the manager’s amendment, the tax will affect “nearly all insurers” starting in 2011.

The excise tax will be based on the insurer’s share of annual net premiums received. The fee will not be tax deductible and apply to all commercial risk business, Medicare Advantage and Medicaid HMOs.

The excise fee will not affect companies that provide “administrative services fees only” from administering ERISA plans nor apply to certain non-profit insurers with medical loss ratios between 90 and 100 percent, an exemption that supposedly applies to non-profits in Michigan and Nebraska.

In 2011, the fee is expected to collect $2 billion; in 2012, $4 billion; in 2013, $7 billion; in 2014 through 2016, $9 billion; in 2017 and beyond, $10 billion.

The current version of the bill would exempt non-profits from the excise tax that spend more than 92 percent of their premiums on healthcare as well as those that provide guaranteed-issue coverage to people unable to get coverage elsewhere.

As for the so-called “Cadillac tax,” starting in 2013, under the bill, all insurers and self-insured companies will be assessed a 40 percent tax on the excess above $9,850 for an individual and $23,000 for a family of four, with a higher threshold for those near-elderly retirees or those having a high-risk job, like policemen, firemen, telephone workers and longshoremen, the analysts said.

AHIP officials also warned that the Senate bill will lead to “more cost shifting to patients with private coverage as providers are forced to make up for hundreds of billions in reduced Medicare payments.”

It will also impose new market and rating rules that will increase premiums for individuals and small businesses with coverage today, AHIP officials said.

According to the CIAB alert, other provisions in the manager’s amendment increase the surtax on families with $250,000 in income (individuals with $200,000 in income) is raised from .5 to .9 percent.

Also, there is a basic exemption for mutual companies that have at least 40 percent market share in any state. And the cosmetic surgery tax is replaced with a tax on indoor tanning services of 10 percent.

I find all of this fairly scary.

[lazarus]

9. they're sourcing from AHIP

which is the insurance company lobby.

[EmeraldCityGrl]

13. I had an excellent doctor a few years ago

that quit his regular practice and started one for the very rich. As far as I understood, he had only a handful of patients
but they had his constant attention and he probably wiped their asses for them. Bill Gates and Paul Allen' were the types
that were his patients. I always assumed they paid cash, but maybe these are the cadillac plans being referred to.

[Blue State Blues]

18. nope that's "concierge service"

"concierge service" -- a growing trend among doctors who are tired of 15 minute appointments. They typically charge an annual fee for being a patient in the practice. They typically take only the insurance plans that offer the highest level of reimbursement (though lots of regular practices refuse to accept "bare bones" insurance plans that not only have low levels of reimbursement, but a history of non-payment on flimsy excuses). But also, by limiting the number of insurances they accept, they limit their administrative costs, since each plan has different paperwork requirements.

Typically doctors in concierge practice serve fewer patients in the practice, promising them more personalized service and longer appointment times -- which would probably lead to better care.

But no, it's not the same thing as so called "Cadillac Plans."

[shawcomm]

8. It should have been so much simpler.

Just open up public hospitals like the VA. Instead, corrupt and idiotic Congress is giving insurance companies a big fat present of our money. This shouldn't have been about insurance at all.

[truedelphi]

25. Especially since from the get go, Obama understood the logical solution.

Like he said again and again, when running for the Illinois Senate, the simplest, most logical way to easily bring about health care reform is:

Single Payer Universal Health Care For All

But then circa December 2007, Obama changes his tune. Just at the time when he is needing the big bucks from the Big Insurers, he began with his Signature BS:

"If we were starting from scratch, the most logical solution would be Single Payer Universal Health Care. But since we have to employ the system we have, then we must devise a solution that will be uniquely American." In other words, even though the system is broken so badly it requires reform, we must stay within that system!!

If the M$M were not totally sold out on this issue, his statement would have been crtiqiued. (The M$M knows that we all channel clique away from the endless ads about prescription drugs, but those ad monies mean the local and national news teams will TOTALLY avoid discussing Single Payer)

[laughingliberal]

10. I have friends in their 50's (a married couple) who pay 24,000 per year for a fairly basic plan

and I know many individuals whose plans run $8500. Why does everyone posting on this ignore the tax on individual plans over $8500. Is it cause they know many individuals over 50 have plans that cost this much or that companies with a lot of older workers often pay this much. Are they trying to downplay the regressiveness of this tax? I'm not well off and our premium to cover my husband in 2004 was $700 per month.

I like the House version. They tax the really well off=people making over $500,000 per year. No doubt in my mind the people in that class can afford it and they've all had tax cuts over the years. Raises 3 time the money and covers more people. Why would we not want to go that way?

[truedelphi]

27. They also conveniently ignore another Great Lie we were sold on.

When they first employed the Federal Income Tax, only the wealthiest of the wealthy paid anything.

And people liked to be photographed at the local IRS writing out the checks. These people werre all millionaires (Which doesn't impress anyone much these days, but back in the Nineteen Teens, when you could buy a house for $ 900 bucks, millionaire status meant a great deal.

Then over time, the tax caught up with everyone. Now the wealthiest of the wealthy do not pay squat, if they have good accountants. And I imagine that a special deduction will come about to help the wealthiest of the weatlthy pay off their encumbrances via this bill, so that Bill Gates will see a way to deduct every penny he spends on is workers, while Sam the Local Barber will be hit with penalties.

[MorningGlow]

35. Same here

My husband just left a job that paid $83K but was killing him (stress exacerbated his high blood pressure). We just got a notice in the mail that if we want to self-pay to keep our current health coverage (family plan with some high copays but no deductible), the price would be $2,200/month--that's $26,400 a year--about 1/3 of his new job's salary.
:wtf:

Of course his new job offers health coverage and we'll sign up there, but seeing the actual cost of a health plan, and calculating how much of his salary would go to it, was eye opening.

[endless october]

14. $8,500 per individual.

won't be long before almost every plan crosses that threshold due to skyrocketing health care costs and no cost controls in the health insurance industry bailout bill.

[shireen]

15. doesn't the premium depend on the pool?

A large company or union with a diverse employee age could get lower premiums because the 'risk' is spread across a population with both young and old -- the lower the median age, the higher the insurance company profits (even with lower premiums) since young people tend to have fewer health problems I think that the people who pay the high premiums for plans with high deductibles and basic coverage tend to be small businesses (if they can afford it) and individuals. Therefore, I'm guessing that high insurance premiums doesn't mean they're 'cadillac plans.'

That's why single payer (or for that matter, a well-run public option) makes sense; it's a huge pool of people, so the risk gets spread out, and costs are further lowered since a government-run plan would be non-profit. Even if the public option pool is mostly people who are uninsurable for health reasons, low income, and includes medicare recipients, the costs would still be pretty low because no profits are being made in a government-run plan.

And that's why i don't understand how $23k is considered a cadillac plan. What am i missing?

[FlaGranny]

16. Eight years ago my premium

would have been over $14,000 for a COBRA extension policy. Other insurance companies would not give me a policy for any price. So I just went without insurance until I was old enough for Medicare. That COBRA policy was not too bad with its benefits, but it was nowhere near "Cadillac." There was no way I could have afforded routine care and still paid the premiums anyway. The only way out for medical care was pay as you go and if something major happened - file bankruptcy. Covering me and my husband would have been well over $23,000. During that time he developed cancer and thankfully was eligible for VA care or else he'd most likely be dead now.

It's a rotten, stinking system.

[laughingliberal]

33. A very common rate for those over 50

And the point is to force everyone into the junk policies. People with "Cadillac" plans (more like overpriced Pinto plans) are the new welfare queens.

[MissB]

17. My employer pays close to $14k per year

My January 1 paycheck stub noted the monthly cost of the employee+family plan to be just under $1200 per month. I don't pay a premium. I do pay a 15% copay up to a $3k deductible on some things (wellness exams and immunizations are
fully covered). I could've chosen a low or no deductible plan but I like our doctors.

Even if you throw in the dental and vision coverage, it still doesn't come anywhere close to that $23k figure.

[Blue State Blues]

19. Ah, but the cost of the plan you have is not necessarily related to the quality

The cost of your plan is based on where you are in the country and how good a deal your employer could negotiate (which generally depends on how large a pool of subscribers your employer can offer to providers, and the average age and health of those subscribers).

So a high-cost plan that qualifies for the tax could be super-duper luxury insurance for executives ... or it could be barely adequate coverage for working people.

If the idea is to lessen the burden on working people, wouldn't it make more sense to directly tax the incomes of the super-rich?

If the idea is to "bend the cost curve," in the absence of strict regulation (which simply isn't going to happen), the best way to do that is to offer a widely available non-profit option to the public ... but no one is still fighting for that.

[mmonk]

20. As a business person, here is how I read it.

The bill is providing a ceiling for policies that cover a lot of things. The policies, when this is implemented, can be adjusted to that price without being taxed. Policies can be marketed to people below that cost by shifting the costs to the consumer (much like the plan I have now since I am over 50, one of the official get screwed populations of this bill, which are high deductable plans). That is how I'm loooking at it from a practical standpoint with a business mind.

It is marketed that one of the great things about this bill is that you can keep the insurance you're on without fear of losing it. Why on earth would I want to?

[uponit7771]

21. Most folk who don't like the bill have not read it

[mmonk]

23. Maybe you can enlighten us as to the Bill's merits?

We need help due to our own fault I suppose.

[laughingliberal]

34. Sorry, I read it and every other bill that was passed out of every committee

And I don't like it. In fact, the more I read the more I dislike. The poison pills in it are endless. The problems we are hearing about are just the tip of the iceberg.

[Ms. Toad]

22. If mine goes up at all, it will be

it is $22,000+ now for decent HMO coverage.

My biggest problem with the Cadillac tax is that it is premium based - rather than being based on the benefits received. Someone downstream suggested it was a progressive tax, but it is not because of how "Cadillac" is determined.

The reason our plan is so expensive is less related to the coverage provide than it is to the fact that we are a small business, rated on the health of its employees. My plan would be far less expensive if I worked for a Fortune 500 company.

I don't think the taxes will hit most of the Union folks who are so upset - typically being in a union means your company is large enough to purchase pool insurance rather than risk rated. It will hit the smaller employers (under 50, to some extent, and under 15 to a far greater extent) who are considerate enough to actually make health insurance available to their employees - most don't because the cost - as a smaller employer - is proportionately greater than it is for larger employers.

I don't really have much of a problem taxing Cadillac plans if the basis for determining Cadillac is the benefits received, not was was extorted from the smaller employers who are already struggling to do the right thing by providing access to insurance.

That said, if the bill(s) work as they are intended, risk based coverage will vanish for smaller employees - and smaller business (and everyone on the higher end just paying for decent coverage) should see significantly lower premiums. There's one place I'd actually like to see a trigger - the tax is implemented ONLY if the exchange drops the average premium significantly.

[Toots]

24. $23,000. for couples, it is $8,500. for an individual

Your plan will be taxed and that tax will be passed on to you the user.

[Romulox]

26. If the tax applies to nobody, it doesn't control costs. Unrec for illogical OP. nt

[OneBlueSky]

28. $12,000 . . . $14,000 . . . $23,000 a year . . . these figures are obscene . . .

particularly when you realize that a big portion goes to the corporations that so graciously provide the insurance . . . no one should have to pay these kinds of premiums for health insurance . . .

[Phoebe Loosinhouse]

29. The figures are obscene. To use them as a jumping off point is ridiculous

HCR was supposed to LOWER costs and make healthcare uniformly accessible. It has not met those goals, since the underlying approach was preserving profits in the first place.

WE will be right back to HCR in 4-5 years or less because NOTHING has been solved.

Time for another Canadian to find this thread and post about his family's coverage for around 1200 a year with NO co-pays or deductables. There was another thread around here where a Norwegian didn't know what a deductable or co-pay was.

If people are too damn stupid to realize how ripped off we are as a nation and a people to get the crappy, inflated, useless, POS "uniquely American" system that we have, then I guess we will never get any better.

[TheKentuckian]

30. It makes no sense to even talk about it's only ___% affected

when we all know good and well that these cost rise quickly, much faster than inflation, and this will result on a cram down on benefits and bigger out of pockets.

In any event its a mess to sell people on and easy to distort granting the best intentions which means that its more trouble than it is worth and a political nightmare.

I want to trust Obama, imagine the doubts those less inclined must feel.

This is bad policy and worse politics.

[Stinky The Clown]

36. Twenty Fucking Nine Fucking Thousand Fucking Dollars a Fucking Year

For an HMO with $5 med and doc copays, including vision, excluding dental.

I am near retirement and have chronic health issues, married to a person who is a bit younger but also has (much more minor) chronic issues.

We pay every fucking penny of this out of pocket. I *am* my employer.

I do not have anything NEAR a Cadillac plan. I have to go where I am told to go to get care. I can choose my doc so long as it is one of the HMO docs.

I must say that, so far, we are happy with our care and with our docs. But we always wait for the shoe to drop.

By the way, when we started with this company 10 years ago, we were under $12K.