• Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

The ACA is a Tax on America's Future


While the direct "tax" of mandatory insurance purchases levied on the public by the ACA is onerous enough, it is the raft of hidden and "stealth" taxes enacted by this legislation that make it such a bad deal for all Americans.

for all Americans

When the Supreme Court voted 5-4 in June to uphold the Accountable Care Act (ACA) on the grounds that the individual mandate requiring citizens to purchase insurance was actually a form of tax, it in effect approved one of the largest tax increases in history. While the direct "tax" of mandatory insurance purchases levied on the public by the ACA is onerous enough, it is the raft of hidden and "stealth" taxes enacted by this legislation that make it such a bad deal .

One obvious example is the ill-conceived 2.3% excise tax on the sale of medical devices that will be imposed on the manufacturers and importers of "an extremely wide range of products, such as surgical gloves, dental instruments, wheelchairs, coronary stents, artificial knees and hips, defibrillators, cardiac pacemakers, irradiation equipment, and advanced imaging technology."

All of these covert taxes will be either passed on to patients or hinder investment in future advances.

Requiring medical device companies to pay this tax out of gross revenues — meaning they have to pay extra whether they are profitable or not — is anti-business and destructive of the entrepreneurial impulses that power one of our most competitive industries, and is contributing to “a drought” in investment in the medical technology industry by venture capital firms.

Medical Inc., an Indiana-based company that makes a variety of medical devices, recently announced that it is “

The tax is already having a negative effect on job growth. To cite one example, Cook

scrapping plans to open five new plants in the Midwest” over the next five years, because it estimates that the 2.3% medical-device tax “will cost it between $20 million and $30 million annually.” Instead of creating hundreds of new jobs for Americans, Cook Medical is instead now looking to expand overseas


To cite another example, officials at Minnesota-based Medtronic, Inc. estimate the tax will cost the company up to $175 million a year, much of which will likely be passed on to consumers in the form of higher prices.

The 2.3% tax on medical devices alone would be reason enough to repeal this law and vote out the politicians responsible for inflicting it upon the public. However, the case against the ACA doesn't end there. The law also imposes an increase in the Medicare payroll tax on high-income individuals and raises taxes on investment income, high-end insurance plans, and drug and insurance industry revenue, all of which risks "depress[ing] the demand for labor at a time when job creation is critical for jump-starting the economy."

Far from helping reduce the debt, as claimed by its supporters, the ACA will add to our debt crisis by enacting a massive expansion of Medicaid and federal tax credits to subsidize the cost of insurance for households with incomes between 138% and 400% of the federal poverty level. Beginning in 2014, “people who are uninsured or buying individual insurance with incomes up to four times the poverty level ($92,200 for a family of four and $44,680 for a single person in 2012) will be eligible for expanded coverage through Medicaid or tax credits to subsidize the cost of private insurance,” according to the Henry J. Kaiser Foundation. This will "add a minimum of 35 million Americans to the entitlement rolls when phased in, at an expense of more than $200 billion annually by the end of the decade."

There are numerous other examples of taxes hidden in the 2,700 pages of the ACA that have received little attention, including:

An increase in the percent of adjusted gross income you'll have to spend on medical expenses before you can claim any deductions

New limits on the amount of pre-tax money that can be placed in flexible spending accounts

Increased penalties for withdrawing funds from health savings accounts for non-medical reasons

We cannot afford this law and the many new taxes and penalties it imposes. This misguided power grab by the federal government will do nothing to contain growing health care costs or improve the delivery of health care in this country. It has set an ominous legal precedent by mandating citizens to purchase something they may not want and risks the health and economic well-being of future generations in pursuit of a social engineering agenda that has been repeatedly rejected by the majority of Americans.

The upcoming election is a chance to reverse course from our current path toward greater government influence and control over the economy exemplified by bureaucracy-creating, private-sector job-destroying laws like the Affordable Care Act. Returning the current administration for a second term will ensure less growth, less economic freedom and greater power for the federal government. Electing a new president and Congress that will make it a day-one priority to repeal the ACA and replace it with sensible, market-driven reforms will be a vital first step in returning our country to the path of economic opportunity and prosperity.

easier, not harder, for America's innovators and creators to build a shared prosperity. That will be good for all Americans.

This November, we can choose to continue to accept the current administration's pessimistic and paternalistic outlook that tells America's entrepreneurs and business owners that they are not the architects of their own success and that they are not contributing their fair share of taxes, or we can elect a candidate who believes in encouraging, not punishing, success and who believes that the key is for government to get out of the way and make it

Related Videos
Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice