WASHINGTON – The New Year brings yet another negative surprise from Obamacare: a raft of new taxes and fees that already are translating into higher health insurance premiums for average Americans.
Blue Cross Blue Shield of North Carolina, the state's largest private health insurer, has notified customers it's raising their premiums by as much as 10 percent in January because of eight new levies and fees in the Affordable Care Act, or ACA.
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Blue Cross linked the increase to taxes and fees taking effect Jan. 1.
"The ACA includes new taxes and fees," the insurance giant told individual policyholders in a three-page letter, titled "Information about Your 2014 Renewal." "The costs required to pay these new taxes and fees are included in your premium and will not be charged separately."
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Blue Cross of Montana sent out a similar notice, while Blue Cross of Alabama cited the taxes on its bills with a separate line item for "Affordable Care Act Fees and Taxes."
Blue Cross polices and costs are expected to set a standard for the industry, influencing how insurers adjust to the law, which is also raising premiums because of mandates that expand coverage and benefits. Aetna has also blamed taxes and fees for coming rate hikes.
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Specifically, the insurance companies have referenced two Obamacare charges taking effect Jan. 1.
One is a flat 2 percent tax on all health insurers, which is expected to raise $8 billion for the administration to help pay costs of the overall act in 2014, but raise health-care premiums for consumers by more than 3 percent. The other is a yearly "reinsurance fee" of $63 per person insured.
There's also a $2 fee per policy that funds a new federal bureaucracy called the Patient Centered Outcomes Research Institute. Insurers also must pay a 3.5 percent user free to sell health plans on the HealthCare.gov website.
Although these taxes are imposed on insurance companies, policyholders end up paying for them in the form of higher premiums. Over the next decade, the Washington-based Heritage Foundation estimates the average American family will pay roughly $5,000 more in premiums to pay for them all.
And these are just the Obamacare taxes and fees that insurers are warning customers they're passing on to them. There are also hidden taxes, such as the medical equipment levy that will make heart valves, stents, pacemakers and other medical devices more expensive.
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All told, there are more than 20 new or higher taxes and fees embedded in the Affordable Care Act – more than half of which affect families earning less than $250,000 a year.
The new taxes, which cost more than $675 billion over the next decade, include:
- A 2.3 percent excise tax on U.S. sales of medical devices that's already devastating the medical supply industry and its work force.
The levy, which took effect Jan. 1, 2013, is a $20 billion blow to an industry that employs more than 360,000 working in plants across the U.S.
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Several major manufacturers have been impacted, including:
- Stryker Corp. of Michigan, which blames the tax for 1,000 layoffs.
- Indiana-based Zimmer Corp., which cites the tax in laying off 450 and taking a $50 million charge against earnings.
- Indiana-based Cook Medical Inc., which has scrubbed plans to open a new U.S. factory each year.
- Boston Scientific Corp., which has opted to open plants in tax-friendlier China and Ireland to help offset a $100 million charge against earnings.
- Minnesota-based Medtronic Inc., which expects an annual charge against earnings of $175 million.
- A $50,000 excise tax on charitable hospitals that fail to meet new "community health assessment needs," "financial assistance" and other rules set by the Health and Human Services Department (took effect in 2010).
- A 3.8 percent surtax on investment income from capital gains and dividends that applies to single filers earning more than $200,000 and married couples filing jointly earning more than $250,000 (took effect Jan. 1, 2013).
- A $24 billion tax on the paper industry to control a pollutant known as black liquor (took effect in 2010).
- A $2.3 billion-a-year tax on innovator drug companies (took effect in 2010).
- A 10 percent excise tax on Americans using indoor tanning salons (took effect July 1, 2010).
- An $87 billion hike in Medicare payroll taxes for employees, as well as the self-employed (took effect Jan. 1, 2013).
- A hike in the threshold for writing off medical expenses to 10 percent of adjusted gross income from 7.5 percent (took effect Jan. 1, 2013.).
- A new cap on flexible spending accounts of $2,500 a year (took effect Jan. 1, 2013).
- Elimination of the tax deduction for employer-provided prescription drug coverage for Medicare recipients (took effect Jan. 1, 2013).
- An income surtax of 1 percent of adjusted gross income, rising to 2.5 percent by 2016, on individuals who refuse to go along with Obamacare by buying a policy not approved by the government (took effect Jan. 1, 2013).
- A $2,000 tax charged to employers with 50 or more workers for every full-time worker not offered health coverage (delayed).
- A $60 billion tax on health insurers (effective Jan. 1, 2014).
- A 40 percent excise tax on so-called Cadillac, or higher cost, health insurance plans (goes into effect Jan. 1, 2018).
