GOP Tax Bill Takes Aim at Affordable Care Act

Tax plan would end individual mandate, raise insurance premiums
Breast Cancer News
November 17, 2017
Eric Fitzsimmons, Copy Editor and Content Coordinator

Editor's Note: Living Beyond Breast Cancer has joined over 20 cancer advocacy organizations to oppose repealing the individual mandate. Let Congress know where you stand. Call or write your senator today.

Republicans in the Senate have reopened debate on the Patient Protection and Affordable Health Care Act, also known as the ACA and Obamacare, by including the repeal of a key part of the law in their proposed tax bill. The late addition to the bill could seriously affect health insurance markets across the country and the people who most need healthcare coverage.

The Senate tax bill would end the individual mandate, the part of the ACA that requires people to get healthcare coverage or pay a fine. Republicans have long targeted the individual mandate as an unpopular part of the law because it is seen as a burden, while many other parts of the ACA, such as patient protections or subsidies for insurance premiums, are seen as benefits. Senator Ted Cruz of Texas and others argue that repealing the individual mandate will be a relief to people who prefer not to get healthcare coverage.

The individual mandate is an important part of how the ACA is designed to provide coverage that is meaningful and affordable to everyone. Under the ACA, insurance companies are required to provide coverage to people who have existing and chronicinfo-icon conditions that may have high medical costs, without charging them more for premiums. 

To keep plans affordable, the individual mandate encourages people to keep insurance coverage when they are healthy. With a mix of people into the market, the cost of covered treatments is spread across a larger group. If the individual mandate goes away, it will be easier for people with low or no expected healthcare costs to drop coverage. With fewer people paying for insurance, premiums go up for everyone, which could drive more people from the market and cause premiums to go up even more.

Repealing the individual mandate could hurt many people who don’t buy insurance and then get unexpectedly sick or injured. But it will definitely hurt many people who have serious conditions, like breast cancer, that come with expensive treatments. If you are getting treatment or feel the need to stay covered, you will find higher premiums and fewer plan options in many parts of the country.

The Congressional Budget Office, a nonpartisan government agency that analyzes laws that affect the budget, estimates 13 million fewer people will have health insurance coverage in 10 years if the repeal goes through, including many who would be eligible for Medicaidinfo-icon. (Many people find out they are eligible for Medicaid when filling out an application on the insurance marketplace, a step they may not get to if they decide it’s cheaper to not get insurance at all.) It also says that premiums will go up 10 percent more than expected under the ACA now. Republicans say these estimates are too large. They argue that the individual mandate does not have that strong an effect on people choosing whether to get healthcare coverage, and the number of people leaving coverage will be smaller.

In previous plans to repeal the ACA, Republicans in Congress replaced the individual mandate with some feature to discourage people from ending their healthcare coverage. One would have made anyone who has a gap in coverage of 3 months or more go through a waiting period before their new insurance started, and another would have allowed insurance companies to add a surcharge to their premiums. The current bill does not include any measure that encourages people to stay covered.

The House of Representatives approved their version of the plan, which does not affect the individual mandate, on November 16. The Senate Finance Committee approved their bill late that same night, but the vote before the Senate is expected to be very close. If that passes, members from the two bodies will draw up a compromise and both houses of Congress will have to approve. Republicans hope to have a tax plan passed and signed into law before the end of the year.

Call your Senator today and share your personal thoughts or concerns about the plan to include healthcare as part of their tax bill. 

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