Hidden tax on expensive health care coverage may hurt public workers

Under the Affordable Care Act (ACA) many states that see the wisdom of compliance are setting up health insurances exchanges, but under a little known provision called the “Cadillac Tax,” public unions in particular may be punished for winning their members generous plans with little flexibility for changing them.

The tax was inserted into the ACA at the last minute with the encouragement of many economists who argued that generous plans made consumers insensitive to the spiraling costs of health care. Plans with greater benefits and coverage gained popularity among government employees, police officers, firefighters and teachers unions, but effectively insulated the individually insured from absorbing the skyrocketing costs of coverage.

The tax will affect public unions employees adversely because their plans, which are covered by collective bargaining measures, are more difficult to change without incurring substantial losses. As a result workers will be penalized by the ACA for having good health care coverage, a result that was not intended according to many economists.

“I think it was misguided all along,” said former labor secretary Robert Reich. He complained that the tax amounted to “a blunt instrument that could too easily become a bargaining chip for cutting back benefits of workers. Apparently, that’s what it’s become.”

According to the tax measure, any plan with a cost above a certain threshold in 2018, $10,200 annually for individual plans and $27,500 for family plans, will be taxed at 40 percent of their costs in excess of the limit. Although some cutoffs exist for retirees and some workers in high-risk professions such as police officers, the tax will hurt a number of public union employees.

Many see a disadvantage here that runs contrary to the spirit of ACA to make health insurance more accessible by making it more affordable. Public employee unions from Boston to Orange County are now trying to find ways of cutting health care benefits to avoid the tax charge set to take place in 2018. However, some economists contend that reining in the costs of health care is what the ACA is primarily designed to do.

“This is intended to shift compensation away from excessively generous health insurance toward wages,” said Jonathan Gruber, an economist at MIT and Obama health care policy advisor.