Revised Senate tax bill includes repeal of individual mandate

Senate Finance Committee Chairman Orrin Hatch (R-UT) last night released a revised version of tax reform legislation that includes a provision to repeal enforcement of the Affordable Care Act’s mandate that most individuals have health insurance. The Congressional Budget Office last week estimated that repealing the individual mandate would decrease the number of individuals with health insurance by 4 million in 2019 and 13 million in 2027. In addition, CBO estimated that premiums in the nongroup health insurance market would increase by about 10% “in most years of the decade” relative to the agency’s baseline. According to CBO, the “effects would occur mainly because healthier people would be less likely to obtain insurance and because, especially in the nongroup market, the resulting increases in premiums would cause more people to not purchase insurance.” CBO also estimates that this provision would save the federal government $338 billion over 10 years, including by reducing federal spending on Medicaid by $179 billion and on Health Insurance Marketplace subsidies by $185 billion. AHA and a coalition of health groups yesterday urged congressional leaders not to include the provision in tax legislation. “We join together to urge Congress to maintain the individual mandate,” the groups wrote. “There will be serious consequences if Congress simply repeals the mandate while leaving the insurance reforms in place: millions more will be uninsured or face higher premiums, challenging their ability to access the care they need. Let’s work together on solutions that deliver the access, care, and coverage that the American people deserve.” In addition to AHA, the groups include America’s Health Insurance Plans, the American Academy of Family Physicians, Blue Cross Blue Shield Association, American Medical Association and Federation of American Hospitals.