GOP sen­a­tors giv­ing tax bill a health rider

In­sur­ance man­date re­peal touted as mid­dle-class re­lief

Arkansas Democrat-Gazette - - FRONT PAGE - In­for­ma­tion for this ar­ti­cle was con­trib­uted by Mike DeBo­nis, Damian Paletta and Carolyn Y. John­son of The Wash­ing­ton Post; by Marcy Gor­don, Kevin Frek­ing and Andrew Tay­lor of The As­so­ci­ated Press; by Thomas Ka­plan of The New York Times; and by Frank E.

WASH­ING­TON — Se­nate Repub­li­can lead­ers are adding a pro­vi­sion to their tax bill that would un­der­mine the Pa­tient Pro­tec­tion and Af­ford­able Care Act, as they now try to ac­com­plish two of their top do­mes­tic pri­or­i­ties in a sin­gle piece of leg­is­la­tion.

Sen. Or­rin Hatch, chair­man of the Fi­nance Com­mit­tee, con­firmed late Tues­day that he was re­vis­ing the bill to in­clude the re­peal of the Af­ford­able Care Act’s in­di­vid­ual man­date — a cen­tral piece of the 2010 law that com­pels most Amer­i­cans to buy health in­sur­ance or pay a fine — “to help pro­vide ad­di­tional re­lief to low- and mid­dle-in­come fam­i­lies.”

“We are op­ti­mistic that in­sert­ing the in­di­vid­ual man­date re­peal would be help­ful; that’s ob­vi­ously the view of the Se­nate Fi­nance Com­mit­tee Repub­li­cans,” Se­nate Ma­jor­ity Leader Mitch McCon­nell, R-Ky., said ear­lier Tues­day, af­ter meet­ing with party mem­bers dur­ing a pri-

vate lunch.

If it be­comes law, the re­peal would save more than $300 bil­lion over a decade but re­sult in 13 mil­lion fewer Amer­i­cans be­ing cov­ered by health in­sur­ance by the end of that pe­riod, ac­cord­ing to the Con­gres­sional Bud­get Of­fice. Repub­li­cans said Tues­day that they would use the sav­ings — which stem from re­duced gov­ern­ment spend­ing to sub­si­dize health cov­er­age — to pay for an ex­pan­sion of the mid­dle-class tax cuts that law­mak­ers had pro­posed.

To be pro­tected from a Demo­cratic fil­i­buster, the tax bill can add no more than $1.5 tril­lion to the fed­eral bud­get deficit over a decade. Repub­li­cans hope the more than $300 bil­lion would help off­set that limit.

At­tempt­ing to use the tax bill to re­peal the man­date marks an abrupt shift in strat­egy as Repub­li­cans at­tempt to use a slim Se­nate ma­jor­ity to pass an over­haul of the U.S. tax code. It scram­bles an al­ready com­pli­cated cal­cu­lus as Repub­li­can lead­ers look to as­sem­ble the 50 votes they’d need to turn their tax bill into law.

Us­ing the bill to at­tack for­mer Pres­i­dent Barack Obama’s sig­na­ture leg­isla­tive achieve­ment likely rules out the al­ready slim pos­si­bil­ity of sup­port from Se­nate Democrats, and the prospect of adding mil­lions to the ranks of the unin­sured will likely trouble some of the same mod­er­ate Repub­li­cans who voted down pre­vi­ous re­peal ef­forts.

Pres­i­dent Don­ald Trump pressed Congress to in­clude the re­peal in their tax ef­forts in a Twit­ter post Nov. 1, but it was re­ceived coolly by GOP lead­ers who feared the same health care pol­i­tics that sunk their pre­vi­ous Af­ford­able Care Act re­peal at­tempts would tor­pedo their tax ef­fort.

Trump and many GOP law­mak­ers have sup­ported us­ing the tax bill to re­peal the man­date, a part of the health care law that cre­ates penal­ties for some Amer­i­cans who don’t buy health in­sur­ance. But un­til Tues­day, Repub­li­cans had re­sisted mak­ing the change, wor­ried that in­ject­ing health care pol­i­tics would im­peril the tax bill.

Sen. Su­san Collins, R-Maine, one of the Repub­li­cans who op­posed pre­vi­ous at­tempts to roll back the health care law, said she was con­cerned about in­clud­ing the man­date re­peal while the Se­nate was still ad­dress­ing a health care com­pro­mise ne­go­ti­ated by Sens. La­mar Alexan­der, R-Tenn., and Patty Mur­ray, D-Wash.

“I per­son­ally think that it com­pli­cates tax re­form to put the re­peal of the man­date in there, par­tic­u­larly if it’s done be­fore the Alexan­der-Mur­ray bill passes be­cause of the im­pact on pre­mi­ums,” Collins said. “I’m go­ing to see what the bill says.”

The up­dated tax bill could, how­ever, in­clude pro­vi­sions of the new bi­par­ti­san health care agree­ment, ac­cord­ing to Collins and Sen. Bob Corker. R-Tenn.

Sen. John Thune, R-S.D., chair­man of the Se­nate Repub­li­can Con­fer­ence and a mem­ber of the fi­nance com­mit­tee that is draft­ing the tax bill, said re­peal would al­low the GOP to fur­ther cut taxes for mid­dle-in­come fam­i­lies.

“It’ll be dis­trib­uted in the form of mid­dle-in­come tax re­lief,” Thune said. “It will give us even more of an op­por­tu­nity to re­ally dis­trib­ute the re­lief to those mid­dle-in­come co­horts who could re­ally ben­e­fit from it.”

Sen. Tom Cot­ton, R-Ark., said in a state­ment Tues­day that he’s glad to see the Se­nate Fi­nance Com­mit­tee tar­get­ing the in­di­vid­ual man­date.

“Re­peal­ing the man­date pays for more tax cuts for work­ing fam­i­lies and pro­tects them from be­ing fined by the IRS for not be­ing able to af­ford in­sur­ance that Oba­macare made un­af­ford­able in the first place,” the Repub­li­can from Dar­danelle said.

He con­tin­ued: “I urge the House to in­clude the man­date re­peal in their tax leg­is­la­tion.”

House GOP lead­ers have said they would ex­plore whether to in­clude a re­peal

of the in­di­vid­ual man­date in their ver­sion of the tax cut bill, but they have so far not made that change.

Sen. Mi­nor­ity Leader Charles Schumer said in­clud­ing a re­peal of the man­date in the tax bill would tor­pedo Demo­cratic sup­port for the Mur­ray-Alexan­der com­pro­mise.

“We don’t need to trade it for a tax bill, and we won’t,” he said.

Sen. Ron Wy­den, D-Ore., the top Demo­crat on the Se­nate Fi­nance Com­mit­tee, slammed the de­ci­sion to in­clude the man­date’s re­peal, say­ing it would “cause mil­lions to lose their health care, and mil­lions more to pay higher pre­mi­ums, all to pay for more tax breaks for multi­na­tion­als.”

‘SE­RI­OUS CON­SE­QUENCES’

Re­peal­ing the man­date would un­der­mine other key parts of the Af­ford­able Care Act.

The health care law banned in­sur­ance com­pa­nies from dis­crim­i­nat­ing against peo­ple with pre-ex­ist­ing health con­di­tions. But in order to pre­vent peo­ple from wait­ing to buy in­sur­ance un­til they got sick, the law also im­posed fi­nan­cial penal­ties for in­di­vid­u­als who did not main­tain health in­sur­ance cov­er­age.

Health ex­perts say elim­i­nat­ing the man­date would desta­bi­lize the in­di­vid­ual in­sur­ance mar­kets set up by the Af­ford­able Care Act, be­cause they would be full of peo­ple with high health care costs but have far fewer of the healthy peo­ple that in­sur­ance com­pa­nies de­pend on to stay prof­itable. In re­sponse, in­sur­ance com­pa­nies would likely ei­ther sig­nif­i­cantly raise pre­mi­ums or pull out of the mar­ket­places en­tirely.

A pow­er­ful group of stake­hold­ers, in­clud­ing the ma­jor health in­sur­ance and hos­pi­tal in­sur­ance lob­bies and two in­flu­en­tial doc­tors’ groups, wrote a let­ter to lead­ers of both par­ties ar­gu­ing that they should re­tain the in­di­vid­ual man­date.

“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,” the groups wrote.

Re­peal­ing the man­date would free up new rev­enue, be­cause fewer peo­ple with health in­sur­ance would mean the gov­ern­ment would spend less on in­sur­ance sub­si­dies, ac­cord­ing to Con­gres­sional Bud­get Of­fice pro­jec­tions. But Repub­li­cans ap­peared to give dif­fer­ing ex­pla­na­tions for what they would do with that money.

McCon­nell, speak­ing at an event hosted by the Wall Street Jour­nal, said the re­peal would al­low them to en­sure cor­po­rate tax cuts re­main per­ma­nent and also to lower taxes for mid­dle-class fam­i­lies.

Trump, how­ever, has said the re­peal should be fo­cused on get­ting in­come tax rates

down for the wealthy, with any left­over money go­ing to­ward cut­ting taxes for the mid­dle class.

Cot­ton and Sen. Rand Paul, R-Ky., had called for the re­peal as part of the tax over­haul. Paul said Tues­day morn­ing that he would in­tro­duce his own amend­ment to the tax bill that would re­peal the in­di­vid­ual man­date and use the sav­ings to lower taxes for mid­dle-class fam­i­lies.

“The man­date re­peal is a prom­ise we all made, and we should keep,” Paul said.

The tax bills in the House and Se­nate would lower taxes for many Amer­i­cans, but non­par­ti­san an­a­lysts have con­cluded that mil­lions would pay higher taxes, par­tic­u­larly if they live in states such as New York, New Jer­sey and Cal­i­for­nia.

Those analy­ses have also con­cluded that the big­gest ben­e­fi­cia­ries of the bills would be cor­po­ra­tions and the very wealthy.

The ad­di­tion of the man­date re­peal again forces Repub­li­cans to grap­ple with their own in­ter­nal di­vi­sions over health care. GOP law­mak­ers spent much of the first eight months of 2011 try­ing to re­peal or roll back the Af­ford­able Care Act. But they were re­peat­edly stymied by GOP de­fec­tions in the Se­nate, with a hand­ful of Repub­li­cans say­ing they wanted the changes to be ei­ther more sweep­ing or done in a bi­par­ti­san way.

Repub­li­cans con­trol 52 votes of the 100-seat Se­nate, and so the loss of sup­port of three of their mem­bers would im­peril any changes to the bill. They are try­ing to pass the tax cut bill through a process known as rec­on­cil­i­a­tion, which means they would need only 50 votes — plus, if nec­es­sary, a tie-break­ing vote from Vice Pres­i­dent Mike Pence — to pass the bill.

The House and Se­nate must pass match­ing ver­sions of the tax cut bill in order for Trump to be able to sign them into law.

House lead­ers are hop­ing to vote on their ver­sion of the mea­sure as soon as Thurs­day. House Speaker Paul Ryan, R-Wis., pro­jected con­fi­dence ear­lier in the day about de­liv­er­ing the leg­is­la­tion.

“This bill will make things bet­ter for hard­work­ing Amer­i­cans,” Ryan told re­porters.

The Se­nate Fi­nance Com­mit­tee is de­bat­ing their ver­sion of the tax bill this week, and Repub­li­cans hope to ap­prove it within days.

Repub­li­cans are hope­ful they can pass a tax bill by early De­cem­ber, though they have a num­ber of other is­sues they need to re­solve, and face the prospect of los­ing a Se­nate seat be­cause of the special elec­tion in Alabama.

The New York Times/AL DRAGO

Se­nate Ma­jor­ity Leader Mitch McCon­nell (right) joins Sen. Patrick Toomey (left), R-Pa., and other GOP sen­a­tors Tues­day in an­nounc­ing that a pro­vi­sion to end the in­di­vid­ual man­date for health care was be­ing added to their tax over­haul plan.

The New York Times/AL DRAGO

Sen. Tom Cot­ton (left), R-Ark., and Sen. Roger Wicker, R-Miss., take the el­e­va­tor Tues­day af­ter the weekly Repub­li­can pol­icy luncheon on Capi­tol Hill. In a state­ment Tues­day, Cot­ton ex­presses sat­is­fac­tion that a re­peal of the in­di­vid­ual health care man­date would be part of the Se­nate GOP tax over­haul plan.

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