First, from law professors Timothy Jost and Joseph White,
[...]a Dec. 3 report in Health Affairs based on a survey of more than 3,000 health plans in 2007 summarizes: "It's often assumed that high-cost health insurance plans - sometimes called 'Cadillac' plans - provide rich benefits to plan subscribers. Health reform provisions that treat these plans like luxuries may be misguided. Only 3.7 percent of variation in the cost of family coverage can be explained by benefit design (actuarial value)." As Allan Sloan explained in the Washington Post on Dec. 18, "as any insurance maven can tell you, costs depend more on the people being covered (old, sick, or both?) and location (high-cost New York or low-cost Montana?) than on the level of benefits."
Second, from Merrill Goozner,
As regular readers of this blog know, I consider it ill-considered and unfair, a tax on people stuck in expensive plans because they belong to groups with older and sicker beneficiaries who use more health services; small groups generally; or who live in areas with expensive delivery systems. The idea that taxing those plans will somehow encourage people to reduce their utilization is wishful thinking that ignores who actually makes health care decisions -- doctors, hospitals, drug companies, and other providers.
It also ignores why most people use health care -- it's because they are sick. The latest research shows less than 4% of the higher cost of some plans is due to extra benefits. Most of the rest is due to the higher claims of people in those more expensive plans, or the fact that the plans cover people in areas with expensive medicine.
To the extent taxing the excess costs will work in getting people to reduce utilization, the studies shows beneficiaries are just as likely to eliminate needed care like preventive medicine as they are to reduce wasteful spending, which is, don't forget, ordered by their physician or the hospitals, who are the primary drivers of the health care train. The tax will do nothing to make providers more efficient or effective in their use of system resources.
Both pieces should be read in the entirety.