How Will the Cadillac Tax Affect Private Insurance Plans?

凯迪拉克税将如何影响私人保险计划？

• 批准号: 8806463
• 负责人: David Powell
• 金额: $ 4.8万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-30 至 2016-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8806463
• 关键词: How; Will; Cadillac; Tax; Affect

DESCRIPTION (provided by applicant): The Affordable Care Act (ACA) significantly changes the United States health care and one of its most major and influential component is the introduction of an excise tax on high premium insurance plans in 2018, commonly referred to as the "Cadillac tax." The tax is designed to increase cost-sharing in health insurance benefit design, decrease medical costs, and act as a primary funding source to counter the insurance expansions in the ACA. Surprisingly, though, the Cadillac tax has received relatively little attention compared to other components of the ACA by researchers. The proposed research aims to fill this gap in the literature by providing both theoretical and empirical research on the implications of the Cadillac tax. A stated purpose of the Cadillac tax is to effectively reduce or even eliminate the tax subsidy for health insurance in the United States tax code. Employers and employees can purchase health insurance in pre-tax dollars, reducing the cost of health insurance and promoting the purchase of overly- generous coverage. The tax subsidy has frequently been blamed for the high use and cost of medical care and economists have attributed annual welfare losses totaling billions of dollars to the tax subsidy. While there is some evidence that the tax subsidy promotes the popularity of "more generous" health insurance, the literature offers little guidance about what "more generous" implies. What would plans look like without the tax subsidy? The proposed project uses a recently-introduced theoretical model which relates the tax subsidy to plan characteristics and cost-sharing generosity. The project will extend this model to account for the Cadillac tax and provide theoretical predictions and guidance for the empirical work and future empirical work in this field The empirical research on the tax subsidy is also limited, focusing on a few select outcomes. The tax subsidy is an especially interesting policy to study because it is similar to the Cadillac tax and there are numerous sources of variation in the tax subsidy which can be exploited for empirical research. This proposed research project will use these sources of variation to understand the implications of the tax subsidy and predict the ramifications of the Cadillac tax in 2018. The project will study the impact on plan characteristics, medical utilization, total medical costs, and insurer payments. We would expect that the Cadillac tax should reduce cost-sharing, reduce insurance generosity, and reduce medical costs. The empirical section of this project will quantify those effects. Using these results, the project will calculate the economic welfare cost of the tax subsidy and potential welfare gains of the Cadillac tax in 2018 and beyond.

描述（由申请人提供）：平价医疗法案 (ACA) 显着改变了美国的医疗保健，其最重要和最有影响力的组成部分之一是 2018 年对高保费保险计划征收消费税，通常称为“凯迪拉克税。”该税收旨在增加健康保险福利设计的成本分摊，降低医疗成本，并作为应对《平价医疗法案》保险扩张的主要资金来源。但令人惊讶的是，与 ACA 的其他组成部分相比，研究人员对凯迪拉克税的关注相对较少。本研究旨在通过提供理论和实证研究来填补文献中的这一空白。 凯迪拉克税的影响。 凯迪拉克税的明确目的是有效减少或 甚至取消美国税法中健康保险的税收补贴。雇主和雇员可以以税前美元购买健康保险，从而降低健康保险成本并促进购买过于慷慨的保险。税收补贴经常被归咎于医疗保健的高使用率和成本，经济学家将每年总计数十亿美元的福利损失归因于税收补贴。虽然有一些证据表明税收补贴促进了“更慷慨”的健康保险的普及，但文献对“更慷慨”的含义几乎没有提供指导。如果没有税收补贴，计划会是什么样子？拟议项目使用最近推出的理论模型，将税收补贴与计划特征和成本分摊慷慨程度联系起来。该项目将扩展该模型以考虑凯迪拉克税，并为该领域的实证工作和未来的实证工作提供理论预测和指导。关于税收补贴的实证研究也很有限，集中于少数选定的结果。税收补贴是一项特别值得研究的有趣政策，因为它与凯迪拉克税类似，并且税收补贴有许多变化来源，可用于实证研究。本拟议的研究项目将利用这些变化来源来了解税收补贴的影响，并预测凯迪拉克税对 2018年。该项目将研究对计划特征、医疗利用率、总医疗费用的影响 费用和保险公司付款。我们预计凯迪拉克税会减少费用分摊，减少保险慷慨，并减少医疗费用。该项目的实证部分将量化这些影响。利用这些结果，该项目将计算 2018 年及以后税收补贴的经济福利成本以及凯迪拉克税的潜在福利收益。