Putting the "Affordable" Back Into the Affordable Care Act

As part of a pledge to protect the middle class, Hillary Clinton is taking a second look at aspects of the ACA that hurt working men and women. That's good news, and the only responsible position for politicians interested in providing more and better healthcare at lower cost.

Unfortunately, fixing the flaws in the ACA will require Secretary Clinton to confront Democrats and former colleagues like Jared Bernstein, who was a top economic advisor in the Obama White House, and MIT's notorious Jonathan Gruber, who consulted with the White House on the ACA.

For example, working off Gruber's 6-year-old talking points, Bernstein recently laid out four reasons to support a 40% excise tax on the health benefits of working people in The Washington Post. None are supported by the facts:

Reason 1: The 40% health care tax is "unlikely to hurt the vast majority of policy holders."

The Facts: The International Foundation of Employee Benefit Plans surveyed over 500 employers and found that 52% were on track to trigger the tax in 2018, and another 13% would not trigger the tax only because they'd already changed their health plans.

Meanwhile, Gruber has now admitted that he expects the excise tax not only to affect nearly all health plans, but also to be a back door repeal of the federal tax subsidy for employer-sponsored health benefits.

Reason 2: "The tax creates an important incentive to hold down coverage costs."

The Facts: Survey after survey finds employers jacking up premiums, deductibles and co pays to avoid the tax. Shifting costs to families that already can't pay their bills is not the same thing as holding down costs, and certainly doesn't control them responsibly. The number of uninsured people plunged last year, but more Americans than ever reported skipping needed care for financial reasons.

Reason 3: "The tax should move much of the money employers were spending on health coverage into paychecks."

The Facts: Come on. When was the last time you saw employers cut costs and turn the "savings" over to workers in higher pay? BNA summed up this nonsense best last month: the idea "elicited laughs from a room filled with attorneys and employee benefits professionals at the American Bar Association Section of Taxation meeting on May 9."

Reason 4: The tax will raise $90 billion over 10 years to reduce the federal budget deficit.

The Facts: Only 2.5% of employers expect to pay the tax. Excise tax revenue has become the Congressional Budget Office's Incredible Shrinking Projection. From January to March, CBO reduced its estimates for tax receipts for the first four years from $87 billion to $25 billion. And that's still a wild overstatement - 75% of the "revenue" is supposed to come not from the tax itself, but from income taxes on all those extra wages that employers are going to give workers.

We're glad to have Secretary Clinton join us to fix the parts of the ACA that are broken. We hope other presidential aspirants, candidates and members of Congress join in this effort. Here are a few points that our union has been making since the day the bill passed, and will continue to make until the White House and lawmakers fix the mistakes of the ACA.

First, how about putting "Affordable" back into the Affordable Care Act? The ACA has increased access - something we support - but the out-of-pocket price is too steep.

Second, if politicians are concerned about helping the middle class, they better think about the stark fact that many aspects of the ACA, including the 40% tax on worker health benefits, cut directly into worker incomes.

Third, if Democrats - and historically anti-tax Republicans -- want to support a 40% tax on workers and their families, they should look our members in the eye tell people who clean bathrooms, make beds, cook breakfast for school kids and wait tables why they have to choose between a 40% tax or paying higher deductibles and having poorer care. How about taxing the incomes of the 1% at a 40% rate first?

Healthcare politics will get more toxic for Democrats as the public watches the health insurance merger and acquisition frenzy. These giants are buying each other up and building monopoly power with more than a trillion bucks of our taxpayer money, all while asking for 20 or even 30 percent premium increases.

With the 2016 campaigns in full swing, from state and local to the presidential election, healthcare will once again be on the ballot. And this is one union that will be basing its support for candidates based on their willingness to make changes to the ACA and put the term "affordable" back in the title.