They’re at it again.
As if the proposed Senate Republican tax plan did not put enough targets on average Americans’ backs, according to multiple reports, the revised bill includes another insult: repeal the Affordable Care Act’s, aka Obamacare, individual mandate.
The individual mandate is the most controversial part of former President Barack Obama’s signature legislation.
It requires all Americans to purchase insurance, particularly the young and healthy, in order to drive down overall cost.
For this there are government subsidies to assist low- to moderate-income Americans who may not be able to afford it.
There is also a penalty for those who refuse–$695 or 2.5 percent of one’s income, whichever amount is greater.
6.5 million Americans paid an average fine of $70 in 2016 for refusing coverage the year before.
Republicans have been attacking that mandate on fiscal grounds ever since the ACA was signed into law.
They are right when they argue repealing the mandate would save more than $300 billion over 10 years.
What they conveniently omit, though, is the Congressional Budget Office’s (CBO) confirmation that savings would come at the expense of millions of Americans left without health insurance, or with sub-par plans, because of the younger and healthier no longer having an incentive to buy insurance, leaving only the older, potentially less well–and more expensive–to insure.
According to the CBO, repealing the individual mandate would increase the uninsured number by $4 million in 2019 and $13 million in 2027. Premiums in the individual market would rise an additional 10 percent.
But saving money at all cost is what Republicans are all about, right?
Under the Republican model, $1.3 trillion in corporate and individual tax cuts that overwhelmingly benefit wealthy Americans will overshadow the $300 billion savings repealing the individual mandate will generate.
On Tuesday, a joint letter to Congress from health insurers, hospitals, and doctors stated:
“Eliminating the individual mandate by itself likely will result in a significant increase in premiums, which would in turn substantially increase the number of uninsured Americans.”
They base their assessment on past practice when some states attempted to expand health insurance coverage without mandates.
Washington state attempted to ban preexisting conditions without any mandate to purchase coverage in the 1990s.
It did not go well.
With only the more expensive insurers taking advantage of it, insurance companies fled. By decade’s end, it was impossible for someone to buy an individual plan in Washington because no company was willing to sell.
A report from the Washington state Insurance Commissioner’s Office described it as a “death spiral,” with customers only buying coverage “when they needed it.”
This caused experts, like MIT health care economist Jonathan Gruber, to affirm:
“It became pretty clear that if you want a market to work, you need a mandate.”
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