Senate Repub­li­cans in­tent on scrap­ping health man­date in tax bill

Pittsburgh Post-Gazette - - Front page - By Marcy Gor­don

As­so­ci­ated Press

WASH­ING­TON — Senate Repub­li­cans are in­tent on scrap­ping the Af­ford­able Care Act’s re­quire­ment that Amer­i­cans get health in­sur­ance, tar­get­ing a re­peal of the in­di­vid­ual man­date to help fi­nance deep tax cuts in their tax over­haul.

The sur­prise re­newal Tues­day of the failed ef­fort to scrap the law’s man­date came a day after Pres­i­dent Don­ald Trump re­newed pres­sure on GOP law­mak­ers to in­clude the re­peal in their tax leg­is­la­tion. It has sharp po­lit­i­cal stakes for Mr. Trump, who lacks a ma­jor leg­isla­tive achieve­ment after nearly 10 months in of­fice.

The move by Repub­li­cans on the Senate Fi­nance Com­mit­tee up­ended the de­bate over the tax mea­sure just as it was inch­ing closer to pas­sage fol­low­ing months of fine-tun­ing and com­pro­mise. It turned the de­bate into an an­gry par­ti­san ref­er­en­dum on health care and for­mer Pres­i­dent Barack Obama’s sig­na­ture law.

Repub­li­can ef­forts to dis­man­tle the law col­lapsed this past sum­mer as mod­er­ate Repub­li­cans

joined with Democrats in re­ject­ing the re­peal — a bit­ter dis­ap­point­ment for Mr. Trump, who lashed out at the Senate GOP for fail­ing. Adding the re­peal of the man­date to the tax mea­sure would com­bine two of Mr. Trump’s leg­isla­tive pri­or­i­ties.

Be­yond Mr. Trump’s prod­ding, the re­peal move also was dic­tated by the Repub­li­cans’ need to find rev­enue sources for the mas­sive tax-cut bill, which calls for steep re­duc­tions in the cor­po­rate tax rate and elim­i­na­tion of some pop­u­lar tax breaks.

“We are op­ti­mistic that in­sert­ing the in­di­vid­ual man­date re­peal would be help­ful; that’s ob­vi­ously the view of the Senate Fi­nance Com­mit­tee Repub­li­cans,” Ma­jor­ity Leader Mitch McCon­nell, R-Ky., told re­porters.

As they do on most leg­is­la­tion, Penn­syl­va­nia’s sen­a­tors staked out opposing po­si­tions.

Demo­crat Bob Casey said, “In ad­di­tion to be­ing a give­away to the su­per-rich and big cor­po­ra­tions, it now ap­pears that the con­gres­sional Repub­li­can tax scheme will also sab­o­tage our na­tion’s health care sys­tem.”

He pointed to an anal­y­sis by the non­par­ti­san Con­gres­sional Bud­get Of­fice show­ing that the re­peal would re­sult in 13 mil­lion fewer in­sured peo­ple.

“In or­der to fi­nance tax give­aways to the wealth­i­est and big­gest cor­po­ra­tions, con­gres­sional Repub­li­cans are will­ing to raise taxes on many mid­dle-class fam­i­lies, elim­i­nate vi­tal de­duc­tions for Penn­syl­va­ni­ans, and bring our health care sys­tem crash­ing down,” Mr. Casey said. “It’s wrong and I will fight against it.”

Repub­li­can Pat Toomey, mean­while, said the in­di­vid­ual man­date is “based on a flawed premise that the fed­eral gov­ern­ment should force Amer­i­cans to buy an over­priced health in­sur­ance plan even if they don’t want it and can’t af­ford it.”

By in­clud­ing it in the tax bill, he said, Congress “gives di­rect re­lief to hard-work­ing Penn­syl­va­ni­ans and as­sists in mak­ing des­per­ately needed changes to our out­dated tax code so Amer­i­can busi­nesses can be glob­ally com­pet­i­tive once again.”

The Trump ad­min­is­tra­tion, which sup­ports re­peal of the in­di­vid­ual man­date, hasn’t taken a firm stance on its in­clu­sion in the tax over­haul bill.

The “Oba­macare” man­date re­quires most peo­ple to buy health in­sur­ance cov­er­age or face a fine. With­out be­ing forced to get cov­er­age, fewer peo­ple would sign up for Med­i­caid or buy fed­er­ally sub­si­dized pri­vate in­sur­ance. Tar­get­ing the man­date in the tax leg­is­la­tion would save an es­ti­mated $338 bil­lion over a decade, which could be used to help pay for the deep cuts.

The Con­gres­sional Bud­get Of­fice has es­ti­mated re­peal­ing the re­quire­ment that peo­ple buy health cov­er­age would mean 4 mil­lion ad­di­tional unin­sured peo­ple by 2019 and 13 mil­lion more by 2027.

It “will cause mil­lions to lose their health care and mil­lions more to lose their pre­mi­ums,” Sen. Ron Wy­den of Ore­gon, the se­nior Demo­crat on the Fi­nance Com­mit­tee, an­grily in­sisted when the panel re­con­vened to work on the tax bill and word came of the Repub­li­cans’ move on the man­date.

Feel­ing ambushed with­out ad­vance no­tice, mi­nor­ity Democrats ex­ploded in anger.

The com­pleted House tax bill, pointed to­ward a vote in that cham­ber Thurs­day, does not cur­rently in­clude re­peal of the health in­sur­ance man­date. Mr. Trump plans an in-per­son ap­peal to House Repub­li­cans be­fore the vote.

To win over mod­er­ate Senate Repub­li­cans to the tax leg­is­la­tion, the Senate may take up at the same time a bi­par­ti­san com­pro­mise to shore up health care sub­si­dies, Sen. John Thune, R-S.D., in­di­cated Tues­day. Mr. Thune is a mem­ber of the Fi­nance panel.

Out­side Congress, as word spread of the Senate Repub­li­cans’ in­ten­tion, ma­jor or­ga­ni­za­tions rep­re­sent­ing in­sur­ers, doc­tors and hos­pi­tals urged law­mak­ers to keep the ACA’s un­pop­u­lar re­quire­ment that most Amer­i­cans have health in­sur­ance — at least for now.

End­ing the “in­di­vid­ual man­date” would prompt healthy peo­ple to leave the in­sur­ance mar­ket in droves, driv­ing up pre­mi­ums, the groups ar­gued in a letter Tues­day to con­gres­sional lead­ers.

Repub­li­can Sens. Rand Paul of Kentucky and Tom Cot­ton of Arkansas had pushed for the re­peal in the tax bill just months after GOP ef­forts to dis­man­tle the 2010 health care law had col­lapsed in the Senate.

“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,” Mr. Cot­ton said in a state­ment.

Con­gres­sional Repub­li­cans pro­jected con­fi­dence ear­lier in the day about de­liv­er­ing the leg­is­la­tion.

“This bill will make things bet­ter for hard-work­ing Amer­i­cans,” House Speaker Paul Ryan, R-Wis., told re­porters.

House GOP lead­ers ral­lied sup­port with the rankand-file at a closed-door meet­ing.

Wash­ing­ton Bureau chief Tra­cie Mau­riello con­trib­uted.

J. Scott Applewhite/As­so­ci­ated Press

Speaker of the House Paul Ryan, R-Wis., fol­lowed at right by Rep. Cathy McMor­ris Rodgers, RWash., walks past boxes of pe­ti­tions sup­port­ing the Repub­li­can tax over­haul bill that is set for a vote later this week. “This bill will make things bet­ter for hard-work­ing Amer­i­cans,” he said.

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