This paper examines the Affordable Care Act's (ACA's) excise tax on high-cost health plans and simulates how tax threshold adjustments and potential behavioral responses by employers and enrollees may affect the prevalence of the tax. Our results show that threshold adjustments that account for high premiums for reasons other than the generosity of benefits, such as adjustments for the age/sex composition of the workforce and geographic variation in health care costs, make a difference in the simulated prevalence of the excise tax and may help target the tax more precisely at plans at the high end of the distribution of health benefits.

中文翻译：

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高成本卫生计划的消费税：政策制定者，雇主和员工的潜在调整

本文研究了《高价医疗法案》（Affordable Care Act，ACA）对高成本卫生计划的消费税，并模拟了税率门槛调整以及雇主和注册人的潜在行为反应如何影响税率。我们的研究结果表明，门槛调整（除了福利的慷慨外）是高保费的原因，例如对劳动力年龄/性别组成的调整以及医疗保健费用的地域差异，对消费税的模拟患病率产生了影响税收，并且可能有助于在健康福利分配的高端计划中更精确地将税收目标确定为税收。