If you thought Republicans had given up trying to repeal chunks of the Affordable Care Act (aka Obamacare), you're wrong. On Wednesday, the Wall Street Journal reported the GOP might throw an ACA individual mandate repeal into its tax reform legislation.
The Obamacare mandate that Republicans want to nix requires most Americans to get insurance coverage through the program, if they aren't already insured through their employer. If they opt out of enrolling in health care altogether, they're forced to pay a fine. Trump supports Republicans' efforts to put an end to the rule. On Wednesday, he tweeted:
Wouldn't it be great to Repeal the very unfair and unpopular Individual Mandate in ObamaCare and use those savings for further Tax Cuts ...
... for the Middle Class. The House and Senate should consider ASAP as the process of final approval moves along. Push Biggest Tax Cuts EVER.
Per the Congressional Budget Office, repealing the mandate could result in a federal deficit reduction of about $400 billion, because those who are forced to purchase health insurance due to the ACA mandate also need federal subsidies. If the mandate is repealed, the government would no longer be responsible for financially helping them to obtain health care. That would also mean, however, that about 15 million fewer Americans would have health insurance over the next 10 years. In addition, fewer people would be insured through Medicaid.
Aside from the amount of funding the ACA mandate requires, however, there's been debate over how effective it was in the first place. In 2016, for example, roughly 8 million people reported paying a penalty for not having coverage under ACA. The average fee per person was around $442, according to the IRS. Considering one of the lowest plans under Obamacare, for individuals over 30, is around $450 per month, a person would still save significantly by forgoing insurance. This lessens the incentive for people to sign up.
For the most part, lawmakers writing the new tax bill have been wary of including a repeal of the mandate. “What I don’t want to do is to add things that could again kill tax reform like health care died over there,” House Ways and Means Chair Kevin Brady told reporters on Tuesday, according Vox. However, Trump's comments have made them reconsider, WSJ reported. Republicans are also weighing adding the mandate repeal in a year-end legislative package instead.
“We’re focused on pushing through tax cuts,” White House Press Secretary Sarah Huckabee Sanders said on Wednesday, stressing that they wouldn't sacrifice that goal in order to repeal the mandate now. But not all Republicans agree with that strategy. Despite the hesitancy, Republican Senator Tom Cotton believes that the repeal could actually help the tax overhaul pass.
“My case, which is making a lot of headway, is this doesn’t make the tax bill harder to pass. It makes it easier to pass,” he said, adding that he's talking to members of both chambers about the decision.
Wednesday was the first day of ACA enrollment for 2018, and the number of people who register for insurance will help determine the program's future. And so far, there hasn't been an overwhelming number of people signing up, according to theWSJ. While there weren't too many technical glitches at Healthcare.gov, a tool that allows individuals to compare plans wasn't working properly and prices were fluctuating in some instances.
Furthermore, despite lots of people sharing the news that Nov. 1 is the first day of open enrollment, the program's uncertain fate under the Trump administration is making potential enrollees hesitant.
"We’re getting questions like, ‘Am I gonna be covered next year?’ or, ‘I’ve heard on the news that there’s no plans available anymore,’” Daniel Bouton, director of community health services at the Community Counsel, told the WSJ.
In regard to the GOP's tax bill, the party is aiming to lower both individual- and corporate-tax rates, but can add no more than $1.5 trillion to the federal budget deficit over 10 years, per Senate rules. Republicans think repealing the mandate will offset the extra costs.
While no Republican has confirmed that the mandate repeal will be included in the tax cut, White House Director of Legislative Affairs Marc Short told the Republican Study Committee it was "not out of the question." Most Republicans have echoed the same sentiment: They are opposed to the mandate, but don't know if this tax bill is the right time and way to address it.