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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsWhy are Democrats in Congress undermining Obamacare? - WaPo Editorial Board
THE $1.4 TRILLION spending bill now making its way to final passage in time to meet a Friday deadline will banish the specter of a partial government shutdown for the foreseeable future. Thats the good news. Otherwise, it is a monumental exercise in fiscal looseness that may add $500 billion to the federal debt over the next decade, according to estimates by the Committee for a Responsible Federal Budget. President Trump and his fellow Republicans deserve much of the blame for this situation, given that, under Mr. Trump, the party has abandoned any pretense of concern over balanced budgets. Yet many of the worst reported provisions enjoy significant Democratic support, too even though they will undermine the signature policy accomplishment of the Obama administration.
We refer to the bills permanent repeal of three key funding sources for Obamacare: a 40 percent excise tax on the value of relatively high-cost Cadillac employer-paid health insurance plans; an annual tax on premiums collected by health insurers, allocated according to each insurer based on market share; and a 2.3 percent excise tax on the value of medical devices sold within the United States. Taken together, the elimination of these revenue-raisers will cost roughly $373 billion over a decade, of which $197 billion comes from repealing the Cadillac tax, $151 billion from ending the fee on health insurers and $25 billion from the tax cut for medical device-makers, according to the Joint Committee on Taxation.
Compounding the damage is the fact that each tax also served legitimate health-market policy goals, in addition to helping pay for expanded coverage. By reducing incentives for excessive consumption of services, the Cadillac tax would have helped slow the overall growth of health costs. As for the health insurance tax and the medical device tax, those are the rough equivalents of partial rebates to the government for the expanded business those firms enjoyed because of Obamacare.
Of course, repeal is a bit redundant in that Congress has delayed or suspended each of the taxes at least once; indeed, the Cadillac tax has never been imposed, because of repeated postponements. Yet permanent elimination represents a final capitulation to the interest groups that opposed them. Both the GOP-aligned U.S. Chamber of Commerce and pro-Democratic labor unions waged a relentless campaign against the Cadillac tax, the former because it was hostile to Obamacare and taxes generally; the latter because union contracts often call for lusher-than-average health benefits. Among the leading Democratic presidential candidates, Sens. Elizabeth Warren (Mass.) and Amy Klobuchar (Minn.) have been particularly dogged foes of the tax on medical devices, in deference to home-state industry. Something to remember as they, and their rivals, promise tax hikes to pay for health-care expansion.
https://www.washingtonpost.com/opinions/why-are-democrats-in-congress-undermining-obamacare/2019/12/17/4a898f76-20f1-11ea-a153-dce4b94e4249_story.html
This is just an example of how hard M4A would be.