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You are here: Home / Anderson On Health Insurance / Delayable deadlines and behavioral changes

Delayable deadlines and behavioral changes

by David Anderson|  December 18, 20152:21 pm| 21 Comments

This post is in: Anderson On Health Insurance

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#CadillacTax’s early impact: 13% of large firms said they had changed their health plans to avoid tax thresholds https://t.co/QZktUUTWdt

— Kaiser Family Found (@KaiserFamFound) December 16, 2015

The Cadillac tax is getting pushed back by two years.  In two or three years, it is likely to be pushed back again as it will only be a future policy and not a current policy which means it is not real yet in political terms.

Last night was the end of the extension of the open enrollment deadline for January 1, 2016 coverage on Healthcare.gov

This was the third year in a row that the January 1 coverage application deadline has been pushed back by forty hours or more.  Yet, it still has not changed the behavior of a massive surge of people trying to enroll on the day of the announced deadline.  At some point, it is a mostly rational bet that the deadline will be pushed back by a day or two, so planning to sign up on the 16th instead of the 15th is a time and frustration saver.  However the announced deadline that most people can assume will be a soft deadline still prompts significant behavioral responses.

I wonder if the Cadillac tax will be like that.  Most people will assume that the Cadillac tax will most likely never be fully implemented, but they will act as if it will, or at least could be implemented to some degree, and continue to trim the highest end plans to minimize potential future exposure.

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21Comments

  1. 1.

    Villago Delenda Est

    December 18, 2015 at 2:36 pm

    Perhaps the lesson here is people don’t want to deal with this insurance shit and long for just having a single payer plan that you’re enrolled in if you’re born here, and never have to worry about this shit ever again.

  2. 2.

    Richard Mayhew

    December 18, 2015 at 2:39 pm

    @Villago Delenda Est: Okay

    Now get the votes to make sure we don’t have to worry about this shit

    If it is so simple and obvious, there should be an easy to assemble majority out there.

    Until then, we muddle through the kludges as best we can.

  3. 3.

    Villago Delenda Est

    December 18, 2015 at 2:45 pm

    @Richard Mayhew: Aye. The problem is that if you label such a plan the right way, a lot of very stupid people (see Kentucky) will vote against their own interests. Calling a system “Obamacare” is both a blessing and a curse, because some really stupid people (again, see Kentucky) will vote against the program they have and like if you call it that, because Obama.

    My desk is getting such a dent in it over this crap.

  4. 4.

    ThresherK (GPad)

    December 18, 2015 at 2:49 pm

    Buying ducats from TicketMaster is just like this, except at the start of the cycle instead of the end.

    How do.we know some GOP rtfcker isn’t having bots swarm all over the website, anyway? I mean, if “denial of service” didn’t already have a definition it would be part of the Republicans’ motto by this point.

  5. 5.

    Baud

    December 18, 2015 at 2:59 pm

    Everyone always waits until the last minute to do everything.

  6. 6.

    raven

    December 18, 2015 at 3:02 pm

    @Baud: I just bought an iPhone 6s for a buck!

    http://money.cnn.com/2015/12/18/technology/best-buy-iphone-6s/index.html

  7. 7.

    Marc

    December 18, 2015 at 3:06 pm

    Things like the “Cadillac” tax are part of the reason for the unpopularity of Obamacare. I understand the logic behind it, but it does directly increase costs for a lot of people if plans have to trim benefits. In our health plan, as a direct result of the prospect of this tax, costs for spouses of employees were dramatically jacked up, as were costs for specialist visits (albeit with no change in the annual maximum out of pocket cost.) This is basically all cost, no benefit to people like me. It doesn’t change the logic of wanting health care for all, but I do question whether all of the parts are sensible.

  8. 8.

    ? Martin

    December 18, 2015 at 3:06 pm

    This is a shame. I don’t understand why luxury health plans should be 100% tax exempt.

  9. 9.

    Punchy

    December 18, 2015 at 3:12 pm

    I avoided the Cadillac tax by buying a Honda.

  10. 10.

    goblue72

    December 18, 2015 at 3:16 pm

    @Punchy: Good one.

  11. 11.

    Germy

    December 18, 2015 at 3:27 pm

    @Villago Delenda Est:

    Perhaps the lesson here is people don’t want to deal with this insurance shit and long for just having a single payer plan that you’re enrolled in if you’re born here, and never have to worry about this shit ever again.

    True.

  12. 12.

    p.a.

    December 18, 2015 at 3:33 pm

    What % of hourly employees will this affect? Are companies using the tax, which maybe affects management overwhelmingly (I’m asking, not asserting), to cut bennies that don’t need to be?

    Anecdote =/= data, but the W2 value of my union negotiated company health insurance is $8,600. (Single coverage, $800 premium, $1,200 deductible, $20/office, $25/specialist, $75 ER, Bl. X Anthem with what I would characterize as a wide network; there are of course out of network costs.) Family plans are valued at $22,000.
    I live in a high cost area; Southern New England.

    Cadillac tax is indexed, I assume to CPI, so there will be bracket creep since health inflation > CPI. But if lots of health ins plans for hourly workers (7% private companies are unionized) are higher value than the above I will be surprised.

  13. 13.

    JustRuss

    December 18, 2015 at 3:43 pm

    @? Martin: What is “luxury” in the context of a health plan? The “luxury” and “Cadillac” framing is BS, unless these plans are covering cosmetic surgery….which I don’t believe to be the case. They’re low-deductible, which encourages people to get care….which is the whole point of having insurance.

  14. 14.

    goblue72

    December 18, 2015 at 3:59 pm

    @JustRuss: The argument is that there is a cost control inefficiency built into the existing system as a result of the fact that healthcare benefits are not subject to income tax. The bulk of Cadillac plans are employer-sponsored. And since the value of the benefit is part of employee compensation but is not taxed, it is basically a tax subsidy that encourages employers to shift total compensation away from wages and into healthcare benefits, and also incentivized employees to use their health insurance excessively since they don’t bear much in the way of cost for using it.

    To the degree the data supports that analysis, its muddy. But that’s the argument.

    A few other things – the Cadillac tax is not assessed agains the full value of the plan. Its only assessed against that portion that is in excess of the threshold ($10,200 for individuals, $27,500 for families). It does NOT include standalone dental, vision, disability or long-term care benefits. However, it does include other forms of healthcare tax shelters, like FSAs, HSAs, etc.

    Also, its not a new idea – it was batted around during the Hillarycare debates in the 1990s.

  15. 15.

    VFX Lurker

    December 18, 2015 at 4:21 pm

    @Villago Delenda Est:

    Perhaps the lesson here is people don’t want to deal with this insurance shit and long for just having a single payer plan that you’re enrolled in if you’re born here, and never have to worry about this shit ever again.

    In 2010, a healthy Facebook acquaintance in Ohio argued with me about health care reform. He disagreed with the concept of single-payer, because he didn’t want everyone to have “the same insurance.” He saw health insurance as a luxury instead of another utility bill, and he didn’t want to lose his ability to express his wealth through superior health insurance in addition to an expensive car and house. As a well-off person, he wanted “better” health insurance than his less well-to-do neighbors.

    In 2014, Vermont backed down from its single-payer plans. The start-up costs surely played a part in killing it, but I wonder how many Vermont voters share the views of my acquaintance in Ohio.

  16. 16.

    RSR

    December 18, 2015 at 4:22 pm

    How does pushing back the ‘Cadillac’ excise tax change the financial ‘success’ of ACA?

  17. 17.

    RSR

    December 18, 2015 at 4:25 pm

    >>If it is so simple and obvious, there should be an easy to assemble majority out there.

    I’ve heard this said about having the IRS compile everyone’s tax return and just have them sign off, yet Intuit’s lobbyists fight off the simple and obvious solution every time it’s considered.

  18. 18.

    ? Martin

    December 18, 2015 at 5:24 pm

    @JustRuss: I had a Cadillac plan. It’s been tweaked to come in under the Cadillac status and now looks a lot like a platinum plan.

    Some things that are covered under my plan:
    Vision, infertility treatments, acupuncture, weight loss surgery, mental health, substance use treatment.

    Keep in mind that an employer can request anything be covered in a plan – they just need to be willing to pay for it. I do know of plans that cover elective plastic surgery. I know of plans that will cover 100% of home health care of family members. I’ve seen plans that will pay for Jenny Craig, for Bosley hair treatments, elective LASIK procedures. You should see what plans for C-level and competitive hires can look like. Consider what the coverage looks like for NFL players.

  19. 19.

    ? Martin

    December 18, 2015 at 5:26 pm

    @RSR:

    How does pushing back the ‘Cadillac’ excise tax change the financial ‘success’ of ACA?

    Some/much of the subsidies were supposed to be paid for by that tax. Without it, ACA looks more and more like a taxpayer drain. If you think the attacks on Medicare and SS are bad, imagine what they will look like for ACA when its primary funding source isn’t so clearly protected.

  20. 20.

    Villago Delenda Est

    December 18, 2015 at 7:07 pm

    @VFX Lurker: Your FB acquaintance is an asshole, I’d say :D

  21. 21.

    p.a.

    December 18, 2015 at 7:47 pm

    @Villago Delenda Est:

    . As a well-off person, he wanted “better” health insurance than his less well-to-do neighbors.

    Agreed about the asshole, but there is nothing incompatible between single payer and the better off buying extra coverage; I believe that’s how it works in much of Europe. What you don’t want is to allow the x% to opt out of the system.

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