Unintended consequence of ‘Cadillac Tax’: Taxing those most in need of care

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Hundreds of thousands of Americans across the country struggle daily with chronic conditions such as primary immunodeficiency diseases (PI), a group of rare genetic disorders in which part of the body’s immune system is missing or functioning improperly. The disorders can affect anyone, regardless of age or gender, and many patients must receive expensive immunoglobulin infusions and other therapies throughout their lives to prevent serious and sometimes deadly infections.

Early diagnosis and appropriate treatment can avoid these outcomes for most and allow them to live normal and productive lives. Until recently, access to treatment has not been a serious problem for most of our patients because nearly all have had some form of health insurance coverage, with 2/3 of them covered by employer-based insurance.

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However, the controversial and so-called “Cadillac Tax,” which was intended to fund the Affordable Care Act (ACA) and minimize healthcare expenditures by discouraging high-value health coverage, represents a huge new threat to the future of patients with PI and other debilitating chronic illnesses. IDF values the protections offered to those living with chronic illness as a result of the ACA and we want to ensure those protections are not threatened by the implications of the Cadillac Tax.

By imposing an annual 40 percent excise tax on employer-sponsored health plans that exceed set government thresholds, the Cadillac Tax assures patients will experience costs shifted their way in the form of higher deductibles, co-payments and out-of-pocket expenses. In the real world, the results of these transferred costs on patients with chronic illness are simple – reduced access to life-enabling and life-saving care.

As the president and founder of the Immune Deficiency Foundation (IDF), the national patient organization for individuals with PI, I’d like to emphasize that this tax is already limiting many critical treatment options including access to specialists, specialty pharmaceuticals and physicians with expertise treating their conditions. For our patients, these treatments, which can be at least $60,000 to $70,000 per year, are often the difference between life and death.

The Cadillac Tax restricts or removes access to appropriate care plans and shifts more out-of-pocket costs to chronically ill patients, putting the cost of necessary treatment so high it is out of reach for many. To put it simply, the Tax is tantamount to the denial of care, increasing the likelihood that the most vulnerable among us will simply forgo treatment. As such, the Cadillac Tax should be renamed the “Ford Focus Tax” for its impact on middle and working class families.

The White House should recognize the unintended consequences and real effects of the Cadillac Tax on patients with chronic and debilitating illnesses and agree with the 90 Senators who voted to repeal this detrimental policy.

The Cadillac Tax puts American lives at risk and creates significant barriers to care for patients living with chronic conditions -- citizens the ACA was intended to protect. A society is judged by how it treats the most vulnerable. What would the judgment be today?

Boyle is president and founder of the Immune Deficiency Foundation.

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