The Affordable Care Act's "Cadillac Plan Tax" is an enormous money-raiser in the long run, as it will, in the long run, substantially remove the tax preference for employers to pay their employees' health-insurance costs.
But is it really the case that nobody ever told Ross Douthat that?
A Hidden Consensus on Health Care: There’s actually a real bipartisan consensus about how the American health care system ought to be reformed…. The politicians’ consensus is that health care reform shouldn’t alter or disrupt the way the majority of Americans get their insurance today…. It’s also the official position of his Republican critics…. The policy consensus, though, is that the status quo is actually the problem… employer-provided coverage [is] an unsustainable relic: a burden on businesses, a source of perverse incentives for the health care market and an obstacle to more efficient, affordable and universal coverage. Yet woe betide the politician who dares to publicly agree. That’s what John McCain discovered in 2008, when he proposed a sweeping reform that would have eliminated the tax incentives that undergird employer-provided coverage… the Obama campaign used it to attack him….
These attacks, in turn, constrained the Obama White House when it came time to design its own health care reform. Obamacare has an unwieldy, Frankenstein’s monster quality in part because the law is trying to serve both consensuses at once. The core of the bill, the subsidies for the uninsured and the exchanges where they can purchase plans, is designed to offer a center-left alternative to the existing system. But much of the surrounding architecture is designed to prop up existing arrangements…
As somebody who made some of those attacks on John McCain, I would point out that the surrounding architecture does not work at cross-purposes to the core but rather supports it: the idea is that the employer-sponsored system should not be dismantled until a better and better-functioning alternative is in place. And our critiques of McCain's 2008 policies were precisely that McCain's policies would dismantle first, create rubble, and then try to build a new system on top of the rubble--and to dismantle the old before the replacement existed seemed to us and seems to us to have been a very bad idea indeed.