Friday, May 13, 2011

The Cadillac Tax Under PPACA-Is It Discriminatory?

Under Health Reform (PPACA), in 2018 the Cadillac Tax will be implemented.  The Cadillac Tax is a 40% Tax on any amount an employer pays for Health Coverage over $10,200 for an individual and $27,500 for a family.  It would seem that this is suppose to discourage companies from offering premium health plans with all the bells and whistles.  Initially when this provision was inked, Unions and the Federal Government employees were exempt.  However, as of now, Unions have been included in the provision. 

The reason that the Cadillac Tax could be considered discriminatory, at least for small employers in the state of Maryland, is that one of the primary factors that determines cost is age.  For example: A HMO (you need to get referrals) through Carefirst with a $20 Co-pay for Primary Office Visits and $30 for Specialist Visits and a $10-$20-$30 Prescription Plan (hardly a Cadillac plan) would cost a company in Baltimore with an average age of 32, $450 for an Individual and $1260 for a family.  This same plan for a company in Baltimore with an average age of 62 would cost $918 for an individual and $2570 for a family or $11,016 per year for individual and $30,840 per year for a family.  As I understand it there are provisions made for slightly higher triggers for older age groups.  However, these rates are for 2011,  if we consider an 8% trend- increase in medical costs per year, the rate could be 60% higher than it is now, easily breaking through those trigger points simply for being an older group. 

In addition, following this logic (if there is any), this could encourage employers to hire younger employees to keep their average age down, reducing their medical premium and keeping them further away from the Cadillac Tax trigger points.  I guess this would be discrimination to avoid an arguably discriminatory provision in the law?????