Author Topic: What comes after the ACA?  (Read 825213 times)

pecunia

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Re: What comes after the ACA?
« Reply #4850 on: October 17, 2018, 07:10:05 PM »

McConnell speaks again about repealing the ACA if they get the votes as well as slashing Medicare and Social Security.

https://www.cnbc.com/2018/10/17/mcconnell-says-senate-republicans-might-revisit-obamacare-repeal.html

Wow!  What a walking hypocrite!

"In a forecast of 2019 policy goals tempered by uncertainty about who will win the congressional elections, McConnell also blamed costly social programs, such as Social Security and Medicare, for the fast-rising national debt."

It's becoming painfully clear to me that fiscal problems are caused by the actions of our elected representatives and not directly by social programs intended to help people.  There's an election coming up.  I guess I'll just have to express my thoughts with my votes.

sherr

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Re: What comes after the ACA?
« Reply #4851 on: October 18, 2018, 07:07:37 AM »

McConnell speaks again about repealing the ACA if they get the votes as well as slashing Medicare and Social Security.

https://www.cnbc.com/2018/10/17/mcconnell-says-senate-republicans-might-revisit-obamacare-repeal.html

Wow!  What a walking hypocrite!

"In a forecast of 2019 policy goals tempered by uncertainty about who will win the congressional elections, McConnell also blamed costly social programs, such as Social Security and Medicare, for the fast-rising national debt."

It's becoming painfully clear to me that fiscal problems are caused by the actions of our elected representatives and not directly by social programs intended to help people.  There's an election coming up.  I guess I'll just have to express my thoughts with my votes.

It's an intentional strategy that plays out on both the federal and state level that the Republicans have employed for decades.

1) First you cut taxes (while also increasing government spending, of course), because who doesn't like paying less taxes? This makes them popular, even as it bankrupts the government.
2) Then when the Democrats are in power you complain about how much of a deficit you have run up and pretend like you are the fiscally responsible party. Then:
2.a) If the Democrats cut military spending you complain about how they're traitors who don't support the troops.
2.b) If the Democrats cut "entitlement" spending like social security or medicaid or school or infrastructure spending you brag to your constituents about how you are good "fiscal conservatives" while the electorate gets mad at the Democrats for the benefit cuts.
2.c) If the Democrats (gasp!) increase taxes to what they were before the tax cut you scream about how they're taking bread out of the mouths of teachers. No one likes tax "increases", so this makes the Democrats incredibly unpopular.

It's a win-win-win political strategy for Republicans. Also known as "starving the beast", look it up. "Increase taxes (on the rich) and increase spending" at least makes back-of-the-napkin mathematical sense. "Cut taxes and increase spending" (what Republicans always do) makes no mathematical or financial sense at all, but it makes political sense which is all they care about.

And yet they still manage to brand themselves as "the party of fiscal responsibility" even as they bankrupt the country and destroy working systems.

The only unique thing here is that they're actually talking about cutting benefits while they're still in power, but I'll believe that it'll happen only after I see it.
« Last Edit: October 18, 2018, 07:09:27 AM by sherr »

talltexan

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Re: What comes after the ACA?
« Reply #4852 on: October 18, 2018, 11:23:59 AM »
This post pretty much nails it. Don't believe it? Read up on the sequester that Obama agreed to with Boehner.

The sad thing was that they let the payroll tax go back up at the start of 2013, Democrats should have kept that one low to help out the little guy.

protostache

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Re: What comes after the ACA?
« Reply #4853 on: October 18, 2018, 11:35:38 AM »
The sad thing was that they let the payroll tax go back up at the start of 2013, Democrats should have kept that one low to help out the little guy.

The payroll tax cut directly affected the longevity potential of the Social Security program and should never have happened in the first place. It actively harmed the "little guy" by making the Social Security trust fund run out faster.

seattlecyclone

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Re: What comes after the ACA?
« Reply #4854 on: October 18, 2018, 11:38:41 AM »
The sad thing was that they let the payroll tax go back up at the start of 2013, Democrats should have kept that one low to help out the little guy.

The payroll tax cut directly affected the longevity potential of the Social Security program and should never have happened in the first place. It actively harmed the "little guy" by making the Social Security trust fund run out faster.

Or we could abolish the social security trust fund because it's just a legal fiction that does more to harm social security than help it. It enshrines into law a requirement that spending on this one program shall never exceed the total revenue from one particular tax. We are happy to borrow money to pay for all sorts of other things. Why not put social security on the same footing as all the other government programs, rather than at a lower priority as is currently the case?

protostache

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Re: What comes after the ACA?
« Reply #4855 on: October 18, 2018, 11:45:51 AM »
The sad thing was that they let the payroll tax go back up at the start of 2013, Democrats should have kept that one low to help out the little guy.

The payroll tax cut directly affected the longevity potential of the Social Security program and should never have happened in the first place. It actively harmed the "little guy" by making the Social Security trust fund run out faster.

Or we could abolish the social security trust fund because it's just a legal fiction that does more to harm social security than help it. It enshrines into law a requirement that spending on this one program shall never exceed the total revenue from one particular tax. We are happy to borrow money to pay for all sorts of other things. Why not put social security on the same footing as all the other government programs, rather than at a lower priority as is currently the case?

I see your point, but putting it off budget with it's own dedicated tax makes it more immune to annual budgetary shenanigans. Putting it out of reach increases it's long term chances of survival. Actual changes have to have broad consensus (or one party with a super majority in the Senate), which is helpful in times like these when that kind of consensus is seemingly impossible.

talltexan

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Re: What comes after the ACA?
« Reply #4856 on: October 24, 2018, 01:08:28 PM »
I cannot help but feel like--in the current environment--a lot of future retirees are going to be very glad that Social Security has its own dedicated revenue source. If Republicans keep control of congress, they're going to want to cut entitlements. If Democrats gain control of congress, they're going to be pressured to cut the deficit.

https://www.newsweek.com/deficit-budget-tax-plan-social-security-medicaid-medicare-entitlement-1172941

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4857 on: October 24, 2018, 01:23:43 PM »
I cannot help but feel like--in the current environment--a lot of future retirees are going to be very glad that Social Security has its own dedicated revenue source. If Republicans keep control of congress, they're going to want to cut entitlements. If Democrats gain control of congress, they're going to be pressured to cut the deficit.

https://www.newsweek.com/deficit-budget-tax-plan-social-security-medicaid-medicare-entitlement-1172941


Or get rid of some of those corporate tax cuts that helped spiral up the deficit.

pecunia

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Re: What comes after the ACA?
« Reply #4858 on: October 25, 2018, 07:05:11 AM »
"Or get rid of some of those corporate tax cuts that helped spiral up the deficit."

People who run corporations are responsible to their owners.

Politicians who run the country are responsible to their corporate owners.

It would be an uphill climb to eliminate those taxes.

iris lily

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Re: What comes after the ACA?
« Reply #4859 on: October 25, 2018, 09:08:11 AM »
I cannot help but feel like--in the current environment--a lot of future retirees are going to be very glad that Social Security has its own dedicated revenue source. If Republicans keep control of congress, they're going to want to cut entitlements. If Democrats gain control of congress, they're going to be pressured to cut the deficit.

https://www.newsweek.com/deficit-budget-tax-plan-social-security-medicaid-medicare-entitlement-1172941

Pressured to cut the deficit? Sure, there will be posturing, and a vote to balance the budget from the minority party, but it is all blather.

talltexan

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Re: What comes after the ACA?
« Reply #4860 on: October 26, 2018, 07:16:34 AM »
Trump would veto any attempt to restore the corporate tax rate back up to the old 35%.

Quiet Saver

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Re: What comes after the ACA?
« Reply #4861 on: October 26, 2018, 09:33:08 AM »
The next best step after or as an amendment to ACA would be to add a US government-sponsored health care alternative similar to Medicare but (1) not specially subsidized by any broad-based tax and (2) available for businesses and uninsured individuals to purchase for their employees or themselves.

The new alternative would be offered along-side private insurance alternatives.  The new alternative would receive the same subsidies, if any, provided by the government to the private insurance alternatives, and it would be subject to the same requirements as the private insurance alternatives for no pre-existing condition exclusions, required inclusion of mental health coverage, etc.  In other words, the new alternative would stand on its own financial bottom and compete in a completely fair manner with the private insurance alternatives.

The advantage of the new alternative is that it would not be burdened by the 15-18% of additional expenses for net revenue, advertising and sales expense, and high executive salaries that private insurance companies impose on their insurance pricing. 

If private employers wanted to purchase the new alternative for their employees instead of buying insurance from the big private insurers they could do so, and if uninsured individuals wanted to buy the new alternative instead of the private insurance alternatives they could do do also. 

My guess is that over time the new alternative would be purchased by more and more employers and individuals, until most of the under-65 population in the US would be covered by a US government plan similar to Medicare, except the under-65 plan would not be subsidized by any broad-based tax.  I also expect Medicaid would disappear and states would spend the same money they spend today buying-in to the new alternative for their Medicaid-eligible residents.

The only remaining Medicaid program would be the one that covers long term nursing home care for low-income residents - Medicare does not cover long term nursing home care; it only covers short term rehabilitation services following a hospital admission.


sol

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Re: What comes after the ACA?
« Reply #4862 on: October 26, 2018, 09:45:18 AM »
Trump would veto any attempt to restore the corporate tax rate back up to the old 35%.

That's not really on the table, though.  Even Obama was trying to lower the corporate tax rate, he was just trying to do it in a way that also balanced the budget by offsetting with other taxes.  The republican's unique contribution was to go full steam ahead with the corporate tax rate without any pretense of fiscal responsibility, knowingly creating enormous deficits in a time of great prosperity.

Democrats aren't proposing restoring the corporate tax rate to 35%.  They're proposing alternative taxes to make up for the lost revenue caused by the corporate tax cut. 

Also of note, neither party is considering cutting spending to match the new lower tax revenues, so this is purely a matter of whether or not the tax cut will be paid for or not. 

shenlong55

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Re: What comes after the ACA?
« Reply #4863 on: October 26, 2018, 10:40:08 AM »
The next best step after or as an amendment to ACA would be to add a US government-sponsored health care alternative similar to Medicare but (1) not specially subsidized by any broad-based tax and (2) available for businesses and uninsured individuals to purchase for their employees or themselves.

The new alternative would be offered along-side private insurance alternatives.  The new alternative would receive the same subsidies, if any, provided by the government to the private insurance alternatives, and it would be subject to the same requirements as the private insurance alternatives for no pre-existing condition exclusions, required inclusion of mental health coverage, etc.  In other words, the new alternative would stand on its own financial bottom and compete in a completely fair manner with the private insurance alternatives.

The advantage of the new alternative is that it would not be burdened by the 15-18% of additional expenses for net revenue, advertising and sales expense, and high executive salaries that private insurance companies impose on their insurance pricing. 

If private employers wanted to purchase the new alternative for their employees instead of buying insurance from the big private insurers they could do so, and if uninsured individuals wanted to buy the new alternative instead of the private insurance alternatives they could do do also. 

My guess is that over time the new alternative would be purchased by more and more employers and individuals, until most of the under-65 population in the US would be covered by a US government plan similar to Medicare, except the under-65 plan would not be subsidized by any broad-based tax.  I also expect Medicaid would disappear and states would spend the same money they spend today buying-in to the new alternative for their Medicaid-eligible residents.

The only remaining Medicaid program would be the one that covers long term nursing home care for low-income residents - Medicare does not cover long term nursing home care; it only covers short term rehabilitation services following a hospital admission.

I think this is a great idea and I'm pretty sure it was talked about during the passing of the ACA.  The government using market forces to push down health care cost. What could be more free market than that, right?  But republicans/conservatives/whatever* will argue that the government has "special efficiencies" or something and that makes it unfair for it to compete in the marketplace like that.  I don't think they understand how that's not really an argument that supports their position...

*Look, I don't know what to call these people anymore.  When I say republican, I get "not all republicans"!  When I say conservative, I get "not all conservatives"!  Maybe if you don't agree with the people in your group that are making these crazy arguments and doing this crazy stuff, then just quite associating with that group already.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4864 on: October 26, 2018, 05:50:59 PM »
The next best step after or as an amendment to ACA would be to add a US government-sponsored health care alternative similar to Medicare but (1) not specially subsidized by any broad-based tax and (2) available for businesses and uninsured individuals to purchase for their employees or themselves.

The new alternative would be offered along-side private insurance alternatives.  The new alternative would receive the same subsidies, if any, provided by the government to the private insurance alternatives, and it would be subject to the same requirements as the private insurance alternatives for no pre-existing condition exclusions, required inclusion of mental health coverage, etc.  In other words, the new alternative would stand on its own financial bottom and compete in a completely fair manner with the private insurance alternatives.

The advantage of the new alternative is that it would not be burdened by the 15-18% of additional expenses for net revenue, advertising and sales expense, and high executive salaries that private insurance companies impose on their insurance pricing. 

If private employers wanted to purchase the new alternative for their employees instead of buying insurance from the big private insurers they could do so, and if uninsured individuals wanted to buy the new alternative instead of the private insurance alternatives they could do do also. 

My guess is that over time the new alternative would be purchased by more and more employers and individuals, until most of the under-65 population in the US would be covered by a US government plan similar to Medicare, except the under-65 plan would not be subsidized by any broad-based tax.  I also expect Medicaid would disappear and states would spend the same money they spend today buying-in to the new alternative for their Medicaid-eligible residents.

The only remaining Medicaid program would be the one that covers long term nursing home care for low-income residents - Medicare does not cover long term nursing home care; it only covers short term rehabilitation services following a hospital admission.

I think this is a great idea and I'm pretty sure it was talked about during the passing of the ACA.  The government using market forces to push down health care cost. What could be more free market than that, right?  But republicans/conservatives/whatever* will argue that the government has "special efficiencies" or something and that makes it unfair for it to compete in the marketplace like that.  I don't think they understand how that's not really an argument that supports their position...

*Look, I don't know what to call these people anymore.  When I say republican, I get "not all republicans"!  When I say conservative, I get "not all conservatives"!  Maybe if you don't agree with the people in your group that are making these crazy arguments and doing this crazy stuff, then just quite associating with that group already.

Yes, the "public option" was much talked about in the liberal press, but the Democrats were too chicken to formally propose it.  Obviously they've never bought or sold a used car.

protostache

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Re: What comes after the ACA?
« Reply #4865 on: October 26, 2018, 05:51:35 PM »
The next best step after or as an amendment to ACA would be to add a US government-sponsored health care alternative similar to Medicare but (1) not specially subsidized by any broad-based tax and (2) available for businesses and uninsured individuals to purchase for their employees or themselves.

The new alternative would be offered along-side private insurance alternatives.  The new alternative would receive the same subsidies, if any, provided by the government to the private insurance alternatives, and it would be subject to the same requirements as the private insurance alternatives for no pre-existing condition exclusions, required inclusion of mental health coverage, etc.  In other words, the new alternative would stand on its own financial bottom and compete in a completely fair manner with the private insurance alternatives.

The advantage of the new alternative is that it would not be burdened by the 15-18% of additional expenses for net revenue, advertising and sales expense, and high executive salaries that private insurance companies impose on their insurance pricing. 

If private employers wanted to purchase the new alternative for their employees instead of buying insurance from the big private insurers they could do so, and if uninsured individuals wanted to buy the new alternative instead of the private insurance alternatives they could do do also. 

My guess is that over time the new alternative would be purchased by more and more employers and individuals, until most of the under-65 population in the US would be covered by a US government plan similar to Medicare, except the under-65 plan would not be subsidized by any broad-based tax.  I also expect Medicaid would disappear and states would spend the same money they spend today buying-in to the new alternative for their Medicaid-eligible residents.

The only remaining Medicaid program would be the one that covers long term nursing home care for low-income residents - Medicare does not cover long term nursing home care; it only covers short term rehabilitation services following a hospital admission.

This is essentially the Medicare Extra for All plan: http://acasignups.net/18/04/11/update-lets-dive-caps-medicare-extra-all

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4866 on: October 26, 2018, 05:55:59 PM »
Trump would veto any attempt to restore the corporate tax rate back up to the old 35%.

That's not really on the table, though.  Even Obama was trying to lower the corporate tax rate, he was just trying to do it in a way that also balanced the budget by offsetting with other taxes.  The republican's unique contribution was to go full steam ahead with the corporate tax rate without any pretense of fiscal responsibility, knowingly creating enormous deficits in a time of great prosperity.

Democrats aren't proposing restoring the corporate tax rate to 35%.  They're proposing alternative taxes to make up for the lost revenue caused by the corporate tax cut. 

Also of note, neither party is considering cutting spending to match the new lower tax revenues, so this is purely a matter of whether or not the tax cut will be paid for or not.

I actually kind of agreed with the corporate tax cut (as did Obama and many Democrats).  I can see how that could stimulate the economy, benefit companies' workers, as well as shareholders and executives, and possibly generate additional tax revenue in the process.  It's the cuts to individual rates for people who are already obscenely wealthy that really piss me off.  And of course, now that those cuts have ballooned the deficit even more than it already was, suddenly we can't afford social security, medicare, or Medicaid any more.

pecunia

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Re: What comes after the ACA?
« Reply #4867 on: October 27, 2018, 12:11:38 PM »
snip
snip

[/quote]

I actually kind of agreed with the corporate tax cut (as did Obama and many Democrats).  I can see how that could stimulate the economy, benefit companies' workers, as well as shareholders and executives, and possibly generate additional tax revenue in the process.  It's the cuts to individual rates for people who are already obscenely wealthy that really piss me off.  And of course, now that those cuts have ballooned the deficit even more than it already was, suddenly we can't afford social security, medicare, or Medicaid any more.
[/quote]

This seems sort of borderline thinking with the Laffer curve.  Businesses will expand when there is an obvious market.  If not, they consolidate their financial position in the marketplace.  I'd guess all this buying back of stock was an example of this.

Aside:  I hope they go back to doing this after the dip in the market.  I'd certainly like to see it go back up.

I think the deficit thing will encourage future inflation.  Despite the rhetoric about the "evil" government, it provides necessary services which must be paid for.  You noted Social Security, medicare and medicaid.  Since they don't have the money, they are borrowing which increases the money in circulation.  More money in circulation means that each dollar is worth less.  If each dollar is worth less, we have inflation.

I really doubt whether the pirates who currently run Congress have the best interests of the American public in mind.  I can't think of anything they are doing to promote the general welfare.  I'm sure there is.

I agree with some sort of government medicine.  If they could get some kind of a crack in the current marketplace, it would begin a big reform of medicine.  Maybe , some sort of government run no profit clinics in the areas where they can't get medical support.  If people saw medicine with no insurance BS attached, it would almost certain to expand.

1WattLightbulb

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Re: What comes after the ACA?
« Reply #4868 on: October 29, 2018, 04:51:51 PM »
I found this Michael Kitces blog post worthwhile: https://www.kitces.com/blog/vanguard-mercer-study-real-annual-health-care-costs-in-retirement-projections/

About halfway into it there's a section on early retirees, which in this case is defined as younger than age 65.

talltexan

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Re: What comes after the ACA?
« Reply #4869 on: October 31, 2018, 08:15:22 AM »
snip
snip


I actually kind of agreed with the corporate tax cut (as did Obama and many Democrats).  I can see how that could stimulate the economy, benefit companies' workers, as well as shareholders and executives, and possibly generate additional tax revenue in the process.  It's the cuts to individual rates for people who are already obscenely wealthy that really piss me off.  And of course, now that those cuts have ballooned the deficit even more than it already was, suddenly we can't afford social security, medicare, or Medicaid any more.
[/quote]

This seems sort of borderline thinking with the Laffer curve.  Businesses will expand when there is an obvious market.  If not, they consolidate their financial position in the marketplace.  I'd guess all this buying back of stock was an example of this.

Aside:  I hope they go back to doing this after the dip in the market.  I'd certainly like to see it go back up.

I think the deficit thing will encourage future inflation.  Despite the rhetoric about the "evil" government, it provides necessary services which must be paid for.  You noted Social Security, medicare and medicaid.  Since they don't have the money, they are borrowing which increases the money in circulation.  More money in circulation means that each dollar is worth less.  If each dollar is worth less, we have inflation.

I really doubt whether the pirates who currently run Congress have the best interests of the American public in mind.  I can't think of anything they are doing to promote the general welfare.  I'm sure there is.

I agree with some sort of government medicine.  If they could get some kind of a crack in the current marketplace, it would begin a big reform of medicine.  Maybe , some sort of government run no profit clinics in the areas where they can't get medical support.  If people saw medicine with no insurance BS attached, it would almost certain to expand.
[/quote]

**Note: this is entirely about the Individual Income tax, NOT the corporate tax side**

The Laffer curve "story" depended on the belief that we are at a tax rate so high that cutting that tax rate would actually increase revenue. There is no evidence that this actually happened, whether with the Reagan tax cuts (1981) or the Bush tax cuts (2001 & 2003). In both of these cases, the large tax cuts were followed by economic growth, but also larger budget deficits.

The Laffer curve "story" is rather something that Plutocrats have used to sell tax cuts to people who really have little to gain from them.

sol

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Re: What comes after the ACA?
« Reply #4870 on: October 31, 2018, 08:26:54 AM »
The Laffer curve "story" is rather something that Plutocrats have used to sell tax cuts to people who really have little to gain from them.

I agree.  The Laffer curve has become something of a joke in economics circles.  An interesting idea that doesn't appear to have ever worked in practice, like Communism and DaVinci's helicopter.  You can rationalize why you think it should work, but it never really seems to work out for some reason.

But we keep hearing about it because it's a useful bludgeon for the rich to use on the poor.  "Vote against your own interests because of this theory I have that never works but I'll get even more super rich if you fall for it!"

In a different world, at a different level of taxation, I would be willing to revisit the Laffer Curve as a serious idea.  But right now, in this world?  It's a bad punchline.

seattlecyclone

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Re: What comes after the ACA?
« Reply #4871 on: October 31, 2018, 12:59:51 PM »
I believe there's probably a tax rate at which the combination of tax cuts and revenue increases predicted by the Laffer Curve would prove true, but we've never been anywhere near there.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4872 on: October 31, 2018, 05:51:25 PM »
Seems like I remember something in Thomas Piketty's book (Capital in the 21st Century) that addressed the Laffer curve issue.  IIRC, he agreed that tax rates would need to be truly confiscatory for a cut to stimulate enough growth to actually increase revenue.

EnjoyIt

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Re: What comes after the ACA?
« Reply #4873 on: November 01, 2018, 03:02:43 AM »
Seems like I remember something in Thomas Piketty's book (Capital in the 21st Century) that addressed the Laffer curve issue.  IIRC, he agreed that tax rates would need to be truly confiscatory for a cut to stimulate enough growth to actually increase revenue.

I wonder at what percentage it starts to feel confiscatory?

As a mustachian, my time is worth a lot and at the peak of my career I started picking up less work because the taxes made it not as worthwhile. But most people are not mustachian and therefor the percent may be higher for them.

High income earners in NYC or California will find themselves paying over 50% in income taxes which may or may not feel confiscatory to some. 
« Last Edit: November 01, 2018, 07:21:50 AM by EnjoyIt »

Classical_Liberal

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Re: What comes after the ACA?
« Reply #4874 on: November 01, 2018, 04:16:57 AM »
As a mustachian, my time is worth a lot and at the peak of my career I started picking up less work because the taxes made it not as worthwhile.

+1 maybe it's just a medical field thing.

Mr. Green

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Re: What comes after the ACA?
« Reply #4875 on: November 06, 2018, 11:19:22 PM »
Well it looks like the Dems are taking the House. Hopefully that means two more years of the status quo re: the ACA. I think in that time we'll see more insurers return to the marketplace and a stronger marketplace overall, making it that much harder for a repeal measure to happen in the future.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4876 on: November 07, 2018, 04:27:42 AM »
Well it looks like the Dems are taking the House. Hopefully that means two more years of the status quo re: the ACA. I think in that time we'll see more insurers return to the marketplace and a stronger marketplace overall, making it that much harder for a repeal measure to happen in the future.

There's still that pesky lawsuit to deal with.  And I suppose it is technically possible that the Republicans could ram through a repeal bill before the new Congress starts in January.  I think the latter is unlikely, but who knows how the lawsuit will turn out.

jim555

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Re: What comes after the ACA?
« Reply #4877 on: November 07, 2018, 04:49:17 AM »
A bunch of red states expanded Medicaid via ballot measure or a governor who will expand.  That makes the ACA harder to get rid of.  A two year reprieve for now.

chasesfish

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Re: What comes after the ACA?
« Reply #4878 on: November 07, 2018, 05:27:18 AM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

Hauser's law - that's something that can be statistically tested:  The total tax revenue to GDP doesn't seem to change much in the US. 

If the tax to GDP rate is driven too low, the country isn't providing 1st world services and/or national security.  One side campaigns on cuts then gets in and realizes there's not much to cut.  Drive the tax rate too high then there's a drag on the economy or people make more decisions based on taxes. 

he countries that have all their medical system run through taxation instead of private insurance tend to have a higher tax revenue to GDP, but its just moving money currently going through a private insurance system as a pass-through for the government. 


Now all that being said - I don't have a hope this next two year term will see any more maturity than the last ten years.  They still won't make the difficult decisions required to make healthcare work.

sherr

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Re: What comes after the ACA?
« Reply #4879 on: November 07, 2018, 07:43:49 AM »
Well it looks like the Dems are taking the House. Hopefully that means two more years of the status quo re: the ACA. I think in that time we'll see more insurers return to the marketplace and a stronger marketplace overall, making it that much harder for a repeal measure to happen in the future.

Y'all are forgetting that the Republicans have already set the "no insurance" penalty to $0 for 2019. That's going to be a huge change. I fully expect a lot of young healthy people to drop out of the market, raising the average cost for everyone else. Whether or not that finally sends the ACA into the "death spiral" that the Republicans have been trying to engineer I guess remains to be seen, but it's not "two more years of the same".

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Re: What comes after the ACA?
« Reply #4880 on: November 07, 2018, 07:47:53 AM »

Hauser's law - that's something that can be statistically tested:  The total tax revenue to GDP doesn't seem to change much in the US. 

As a "law" Hauser's law seems to apply only if you make it really flexible. 

Quote
Historically, since the end of World War II, federal tax receipts as a percentage of gross domestic product averaged 17.9%, with a range from 14.4% to 20.9% between 1946 - 2007.

It seems more that there is a "tax appetite" that is the average of what the two parties have been able to enact over time.  Dems raise taxes, GOP lowers them, swinging back and forth.  Magnitude of change is limited, as is duration of power.  If we had a different post-WW2 anchor point, the percentage might be different.

What's more interesting (and contentious) than the absolute tax rate is how that burden is distributed among the populace.

weirdlair

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Re: What comes after the ACA?
« Reply #4881 on: November 07, 2018, 09:04:18 AM »
I was searching for a list of the changes to the Affordable Care Act since Trump took office, and found this article: https://medcitynews.com/2018/04/aca-timeline-illustrates-health-law-changed-since-trump-took-office/

It lists what has happened to the ACA by date, and includes some supporting links. For example, this is the first entry:

Quote
Jan. 20, 2017:

On his first day in office, Trump issues an executive order to “minimize the unwarranted economic and regulatory burdens” of the health law. It includes instructions to agencies to “exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden.”

Does anyone have a better source of the changes that have been made to the ACA by Trump and his admin?

EnjoyIt

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Re: What comes after the ACA?
« Reply #4882 on: November 07, 2018, 11:04:15 AM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

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Re: What comes after the ACA?
« Reply #4883 on: November 07, 2018, 12:38:49 PM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

Right, but mostly people don't have the flexibility, so the net tax revenues would likely be significantly less if they lowered the rates enough for you to continue with your full time job.

pecunia

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Re: What comes after the ACA?
« Reply #4884 on: November 07, 2018, 04:56:13 PM »
They say one of the big concerns in this recent election was health care.  I knoww my local GOP rep had hs toughest race yet against a doctor who was running on single payer.  I wonder if the Republicans are smart enough to realize that this is an issue that could really go bad for them.  It is not going to go away.  I also wonder if the Democrats are smart enough to use this issue to their advantage.

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4885 on: November 07, 2018, 06:04:38 PM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

The highest marginal tax rate in the US is currently 37%, and if you are MFJ, that rate only applies to earned income in excess of 600,000.  You're not paying any SS tax on anything you earn after 128,400.  Medicare tax is only 1.45%.  So at most, Uncle Sam is taking 38.45% of what you would earn if you work more, leaving you to keep nearly 62%.  Are you sure you're thinking this through?  Or maybe your state has an outrageous income tax rate? 

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Re: What comes after the ACA?
« Reply #4886 on: November 07, 2018, 06:18:47 PM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

The highest marginal tax rate in the US is currently 37%, and if you are MFJ, that rate only applies to earned income in excess of 600,000.  You're not paying any SS tax on anything you earn after 128,400.  Medicare tax is only 1.45%.  So at most, Uncle Sam is taking 38.45% of what you would earn if you work more, leaving you to keep nearly 62%.  Are you sure you're thinking this through?  Or maybe your state has an outrageous income tax rate? 
Right, 62% is the best case scenario, if he is an employee (many doctors are not) in one of the rare states that doesn't tax income. Take out an additional 10-13% for places like Portland, NYC, Chicago, or anywhere in California.

EnjoyIt

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Re: What comes after the ACA?
« Reply #4887 on: November 07, 2018, 10:13:47 PM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

The highest marginal tax rate in the US is currently 37%, and if you are MFJ, that rate only applies to earned income in excess of 600,000.  You're not paying any SS tax on anything you earn after 128,400.  Medicare tax is only 1.45%.  So at most, Uncle Sam is taking 38.45% of what you would earn if you work more, leaving you to keep nearly 62%.  Are you sure you're thinking this through?  Or maybe your state has an outrageous income tax rate? 
Right, 62% is the best case scenario, if he is an employee (many doctors are not) in one of the rare states that doesn't tax income. Take out an additional 10-13% for places like Portland, NYC, Chicago, or anywhere in California.

That is correct.  I am also self employed so medicare tax is 2.9% plus the Obamacare surtax of 0.9% totaling 3.8%.  Then you have to consider the 3.8% Obamacare surtax on capital gains as well. 

Frankly it just isn't worth it to work those extra days for about 50% of my take home pay.  I might as well work an extra year part time and pay half as much in taxes while enjoying more free time today. Part time I work a total of less hours and actually take home more money.

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Re: What comes after the ACA?
« Reply #4888 on: November 07, 2018, 10:41:48 PM »
Part time I work a total of less hours and actually take home more money.

That is not how taxes work.  Are you suggesting that working more to cross into a higher tax bracket reduces your take home pay?


Classical_Liberal

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Re: What comes after the ACA?
« Reply #4889 on: November 07, 2018, 11:18:33 PM »
Part time I work a total of less hours and actually take home more money.

That is not how taxes work.  Are you suggesting that working more to cross into a higher tax bracket reduces your take home pay?

That is exactly how taxes work.  If I have options like: 1)Work one year Full time+ and make 150K or 2) Work three years at 1/3 time and make 50K, I net substantially more in option 2 for the same number of hours worked. 

This is a problem unique to those of use who can easily afford to live off of 1/3 or less of pay.  In the medical field many can also get near full benefits at 1/3 time, reducing expenses in year 2 and 3 further.   


Monkey Uncle

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Re: What comes after the ACA?
« Reply #4890 on: November 08, 2018, 04:32:42 AM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

The highest marginal tax rate in the US is currently 37%, and if you are MFJ, that rate only applies to earned income in excess of 600,000.  You're not paying any SS tax on anything you earn after 128,400.  Medicare tax is only 1.45%.  So at most, Uncle Sam is taking 38.45% of what you would earn if you work more, leaving you to keep nearly 62%.  Are you sure you're thinking this through?  Or maybe your state has an outrageous income tax rate? 
Right, 62% is the best case scenario, if he is an employee (many doctors are not) in one of the rare states that doesn't tax income. Take out an additional 10-13% for places like Portland, NYC, Chicago, or anywhere in California.

That is correct.  I am also self employed so medicare tax is 2.9% plus the Obamacare surtax of 0.9% totaling 3.8%.  Then you have to consider the 3.8% Obamacare surtax on capital gains as well. 

Frankly it just isn't worth it to work those extra days for about 50% of my take home pay.  I might as well work an extra year part time and pay half as much in taxes while enjoying more free time today. Part time I work a total of less hours and actually take home more money.

That still only adds up to a hair under 41%.  If you're in a high tax state, you could easily be paying 9% or more in state income tax to get you to that 50% number.  You'd still be taking home a lot of money, though.   But if I were making over 600k per year, no amount of additional money could entice me to work more.  Taxes wouldn't even enter into the decision.  I guess that point of "not worth it" is likely to vary a lot from person to person.

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Re: What comes after the ACA?
« Reply #4891 on: November 08, 2018, 05:13:21 AM »
The next best step after or as an amendment to ACA would be to add a US government-sponsored health care alternative similar to Medicare but (1) not specially subsidized by any broad-based tax and (2) available for businesses and uninsured individuals to purchase for their employees or themselves.

The new alternative would be offered along-side private insurance alternatives.  The new alternative would receive the same subsidies, if any, provided by the government to the private insurance alternatives, and it would be subject to the same requirements as the private insurance alternatives for no pre-existing condition exclusions, required inclusion of mental health coverage, etc.  In other words, the new alternative would stand on its own financial bottom and compete in a completely fair manner with the private insurance alternatives.

The advantage of the new alternative is that it would not be burdened by the 15-18% of additional expenses for net revenue, advertising and sales expense, and high executive salaries that private insurance companies impose on their insurance pricing. 

If private employers wanted to purchase the new alternative for their employees instead of buying insurance from the big private insurers they could do so, and if uninsured individuals wanted to buy the new alternative instead of the private insurance alternatives they could do do also. 

My guess is that over time the new alternative would be purchased by more and more employers and individuals, until most of the under-65 population in the US would be covered by a US government plan similar to Medicare, except the under-65 plan would not be subsidized by any broad-based tax.  I also expect Medicaid would disappear and states would spend the same money they spend today buying-in to the new alternative for their Medicaid-eligible residents.

The only remaining Medicaid program would be the one that covers long term nursing home care for low-income residents - Medicare does not cover long term nursing home care; it only covers short term rehabilitation services following a hospital admission.

This is exactly what we need.  And it was included in the original ACA, but the health insurance companies lobbied HARD against it.  Since Congress is owned by the corporations, it got dropped.  This is the best way to move toward single payer as it would happen gradually.

It has to happen eventually.  The current system is not sustainable.

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Re: What comes after the ACA?
« Reply #4892 on: November 08, 2018, 05:14:19 AM »
The problem with the Laffer Curve argument is "there are lies, damn lies, and statistics".  I don't think I've ever seen an objective argument from either side on this.  It gets manipulated to prove a point.

The only argument I can event remotely produce is me. For a few years now I have chosen to work less because I did not feel my time is worth the extra income when such a huge chunk of it is taken by taxes.  The higher taxes made a big difference where I would have chosen to work a little more and get to 25x sooner, but at the high tax rate I just did not think it was worth it.  I could just put in an extra 1.5-2 years part time at much lower tax brackets and get to the same goal with less stress.

*Raises Hand* - We're guilty as charged on reducing work due to taxes.

Wife was practicing as a veterinarian and we lived in Georgia.  No kids and I was making a little over $120k.  We did the math and her federal, state, FICA, and medicare liability on her $72k salary was going over 40%.  She quit work, it wasn't worth being paid 58 cents on the dollar for incremental money we didn't really need.  We focused on my income after that since everything earned was over the FICA cap...and we also moved to a state without an income tax

EnjoyIt

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Re: What comes after the ACA?
« Reply #4893 on: November 08, 2018, 06:13:16 AM »
Part time I work a total of less hours and actually take home more money.

That is not how taxes work.  Are you suggesting that working more to cross into a higher tax bracket reduces your take home pay?

That is exactly how taxes work.  If I have options like: 1)Work one year Full time+ and make 150K or 2) Work three years at 1/3 time and make 50K, I net substantially more in option 2 for the same number of hours worked. 

This is a problem unique to those of use who can easily afford to live off of 1/3 or less of pay.  In the medical field many can also get near full benefits at 1/3 time, reducing expenses in year 2 and 3 further.

It gets even worse because as income grows you start getting phased out of other deductions or money saving schemes. 

Don't get me wrong.  This is not a poor pathetic high income earner complaining about his taxes.  I am simply stating a fact that I choose to work less because of our progressive tax structure.  The extra stress and risk of liability is simply not worth my time at a ~50% tax rate.

BTW, I have a few higher income earner friends whose spouses do not work because of taxes.  Add in the need for purchasing childcare when both parents work and the spouse working could actually become a net loss.

Lastly, I have seen evidence of Mustachians cutting their income not just through tax deductions but also through hours worked to hit the ACA subsidies threshold. Move evidence of how our progressive laws stifle productivity.

Just to give a counter example.  I have a buddy who owns a large business in California making well over a million a year.  He pays more than 50% in taxes and still looking to grow the business and make more. Of course he often spends money sometimes faster than he could make it so there is that.

That still only adds up to a hair under 41%.  If you're in a high tax state, you could easily be paying 9% or more in state income tax to get you to that 50% number.  You'd still be taking home a lot of money, though.   But if I were making over 600k per year, no amount of additional money could entice me to work more.  Taxes wouldn't even enter into the decision.  I guess that point of "not worth it" is likely to vary a lot from person to person.

It sure is a lot of money but like you said it is not worth it for me considering the stress, the liability risk, and the earlier burnout risk. Lets look at a straw man hypothetic example.  You work on a construction site using a sledgehammer all day long to break up large rocks into smaller rocks.  You get paid $10/hr and after taxes you are taking home about $9.  Then the manager comes to you and says.  Monkey Uncle, can you come in on Saturday and break up those rocks over there pointing to a big pile. But, instead of taking home $9/hr you will take home $7/hr after taxes.  Sure, $7/hr is decent cash but is it worth breaking my back and risking a shoulder injury? Instead I can rest on Saturday making sure I have some longevity in my rock smashing career and instead work for $9/hr take home pay.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4894 on: November 08, 2018, 07:52:32 AM »
You blame the tax structure as the root of the reason but I disagree. It's simply the marginal utility of the extra dollar of income earned is not as valuable to you as the free time you'll get.
You've basically made the case here for early retirement for people with the luxury of salaries that afford them that possibility.

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Re: What comes after the ACA?
« Reply #4895 on: November 08, 2018, 08:17:13 AM »
BTW, I have a few higher income earner friends whose spouses do not work because of taxes.  Add in the need for purchasing childcare when both parents work and the spouse working could actually become a net loss.
Pardon my ignorance. How is childcare expense related to taxes? As I understood it, filing taxes jointly with widely disparate incomes results in quite favorable tax rates.

Quote from: EnjoyIt
Lastly, I have seen evidence of Mustachians cutting their income not just through tax deductions but also through hours worked to hit the ACA subsidies threshold. Move evidence of how our progressive laws stifle productivity.
Reminder: the ACA was a Conservative concept. The core concept came from The Heritage Foundation, and was first implemented by Mitt Romney. The progressive idea is single payer healthcare, which would address your concern about healthcare cliffs.

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Re: What comes after the ACA?
« Reply #4896 on: November 08, 2018, 08:25:34 AM »
BTW, I have a few higher income earner friends whose spouses do not work because of taxes.  Add in the need for purchasing childcare when both parents work and the spouse working could actually become a net loss.
Pardon my ignorance. How is childcare expense related to taxes? As I understood it, filing taxes jointly with widely disparate incomes results in quite favorable tax rates.

You get the most favorable tax treatment (relative to what you'd pay as two single people) if you are married filing jointly but only one of you has any income at all. <-- which is just taking the point you made above to its logical extreme.

If partner A is already making 600k/year, if partner B starts a job, they'll be paying full social security tax (which A has maxed out) plus they are paying the highest marginal income tax rate starting from the first dollar they earn. So the more money your spouse makes, the harder it is for you to earn enough money (after taxes) to cover the cost of the childcare your household will need to pay for if both parents work.

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Re: What comes after the ACA?
« Reply #4897 on: November 08, 2018, 08:36:52 AM »
Another example here where my wife chose not to work because of high taxes. She proposed applying for an open, part time, minimum wage job as a playground aid at the school. I opened up turbo tax and demonstrated what she would be able to keep after filing a joint tax return. She was not interested in working half of her time for taxes.

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Re: What comes after the ACA?
« Reply #4898 on: November 08, 2018, 11:15:12 AM »
You blame the tax structure as the root of the reason but I disagree. It's simply the marginal utility of the extra dollar of income earned is not as valuable to you as the free time you'll get.
You've basically made the case here for early retirement for people with the luxury of salaries that afford them that possibility.

I blame nothing.  I look at the math for me and decided on what is the best course of action.  If I was taxed less I would likely have stayed full time a little longer instead of working part time.  Full time just makes no sense. It was mentioned that people do not make productivity decisions based on taxes and I am saying that I did as well as a few other people who have chimed in this thread.

Quote from: EnjoyIt
Lastly, I have seen evidence of Mustachians cutting their income not just through tax deductions but also through hours worked to hit the ACA subsidies threshold. Move evidence of how our progressive laws stifle productivity.
Reminder: the ACA was a Conservative concept. The core concept came from The Heritage Foundation, and was first implemented by Mitt Romney. The progressive idea is single payer healthcare, which would address your concern about healthcare cliffs.

Not sure why you bring up conservative vs. liberal or who invented the ACA.  it makes no difference to me since I am a mixture of the two.  ACA is the law of the land and people make decisions based on that law.  Some have decreased their income by working less to get the subsidy.  I don't blame them, but it does show examples of how laws and taxes can stifle productivity and actually decrease the income coming into the government.

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Re: What comes after the ACA?
« Reply #4899 on: November 08, 2018, 01:09:06 PM »
BTW, I have a few higher income earner friends whose spouses do not work because of taxes.  Add in the need for purchasing childcare when both parents work and the spouse working could actually become a net loss.]

You get the most favorable tax treatment (relative to what you'd pay as two single people) if you are married filing jointly but only one of you has any income at all. <-- which is just taking the point you made above to its logical extreme.

If partner A is already making 600k/year, if partner B starts a job, they'll be paying full social security tax (which A has maxed out) plus they are paying the highest marginal income tax rate starting from the first dollar they earn. So the more money your spouse makes, the harder it is for you to earn enough money (after taxes) to cover the cost of the childcare your household will need to pay for if both parents work.

Ah, touche! Thank you for explainin'!

Quote from: EnjoyIt
Not sure why you bring up conservative vs. liberal or who invented the ACA.  it makes no difference to me since I am a mixture of the two.  ACA is the law of the land and people make decisions based on that law.  Some have decreased their income by working less to get the subsidy.  I don't blame them, but it does show examples of how laws and taxes can stifle productivity and actually decrease the income coming into the government.

I was responding to this piece, specifically:

Quote from: EnjoyIt
...Move evidence of how our progressive laws stifle productivity.

Seemed like a slight against "progressives". Maybe I misunderstood.