ACA Agonistes
Hillary Clinton Comes out Against Obamacare Tax

The Clinton campaign is expected to break with the Obama administration and call for the repeal of the Affordable Care Act’s “Cadillac tax”, dealing a blow to the front of Democratic unanimity around the president’s signature legislative achievement. Clinton is not attacking the tax from the right; rather, she is joining Bernie Sanders in attacking it from the left and under pressure from unions. The New York Times reports:

Hillary Rodham Clinton will in the coming days speak out against the so-called Cadillac tax on certain health care plans, a move that is part of a series of reforms she’s suggesting for the Affordable Care Act, according to a union official briefed on her plans.

Mrs. Clinton’s campaign aides informed Randi Weingarten, the president of the American Federation of Teachers, of her intentions in the last few days, according to a senior official with the labor group. The union made an early endorsement of Mrs. Clinton in July.

Many of the union’s members would be affected by the Cadillac tax, which imposes taxes on pricey employer-based coverage plans whose premiums exceed $10,200 a year for individuals and $27,500 for families. The tax is imposed on employers, who can avoid it by reducing benefits to their workers. Its purpose is to help rein in health care costs over all.

The growing chorus of figures on both sides announcing their opposition to the tax highlights one of the major challenges for Obamacare: It’s expensive, and even Democrats can’t agree on how to pay for it. The Cadillac tax was expected to raise $87 billion in 10 years. As Noah Rothman pointed out, Clinton has only said that she will make up for the revenue using “other means”—meaning in all likelihood a different tax that is less painful for Democratic constituencies.

But either way, this story shows that debate over the law is not yet over. Some provisions, including but not at all limited to the Cadillac tax, have not even been implemented yet, and others, like the employer mandate, have always had critics on the left. It’s too early for anyone to declare victory in the Obamacare wars when battles over the law’s implementation remain.

But in the end, it’s key to remember that tinkering around the edges of Obamacare is not a healthcare policy. We need a radical rethinking of the American healthcare system to bring costs under control. Cadillac tax or no, American healthcare is too expensive, and in desperate need of major, market-oriented reforms, like better use of remote monitoring and expanded scope of practice for nurse practitioners, to make U.S. healthcare delivery better, faster, and cheaper.

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