Senate GOP adds ACA re­peal to tax bill

Pro­vi­sion end­ing in­di­vid­ual man­date could make its pas­sage dif­fi­cult

Sun Sentinel Palm Beach Edition - - NATION & WORLD - By Lisa Mas­caro and Jim Puz­zanghera Wash­ing­ton Bureau Staff writer Noam Levey in Wash­ing­ton con­trib­uted.

WASH­ING­TON — Senate Repub­li­cans took a big gam­ble Tues­day with their tax re­form bill, adding a par­tial Af­ford­able Care Act re­peal pro­vi­sion that will free up more money for tax cuts, but also in­ject sig­nif­i­cant new po­lit­i­cal hur­dles.

The change, backed by Pres­i­dent Don­ald Trump and a hand­ful of sen­a­tors, would end the man­date un­der the Af­ford­able Care Act — also known as Oba­macare — that all Amer­i­cans have health cov­er­age. Senate GOP lead­ers had pre­vi­ously re­jected the idea as too risky to in­clude in their tax pack­age, par­tic­u­larly after the re­peated failed ef­forts ear­lier this year to re­peal the ACA.

Re­peal­ing the man­date would save the gov­ern­ment an es­ti­mated $338 bil­lion over 10 years, but only be­cause mil­lions of peo­ple would stop buy­ing in­sur­ance and there­fore would no longer re­ceive sub­si­dies.

Look­ing for way to fund their am­bi­tious tax plan and un­der fire for giv­ing most of the breaks to cor­po­ra­tions and the wealthy, Senate Repub­li­cans made a last­minute de­ci­sion to in­sert the Oba­macare re­peal. They plan to use the sav­ings to pay for ad­di­tional tax cuts for mid­dle- and up­per-class Amer­i­cans.

“It’ll be dis­trib­uted in the form of mid­dle in­come tax re­lief,” said Sen. John Thune of South Dakota, the third-rank­ing Repub­li­can.

It re­mains to be seen whether Senate lead­ers can muster the 50 votes needed from their own party to pass the new ver­sion, though they ex­pressed con­fi­dence. “We’re op­ti­mistic that in­sert­ing the in­di­vid­ual man­date re­peal would be help­ful,” Senate Ma­jor­ity Leader Mitch McCon­nell, R-Ky., said.

As a pos­si­ble con­ces­sion to lure cen­trist Repub­li­cans who sank pre­vi­ous ef­forts to re­peal the health care law, Senate lead­ers in­di­cated they would move ahead with a bi­par­ti­san health care com­pro­mise bill worked out by by Sen. La­mar Alexan­der, R-Tenn., and Sen. Patty Murray, DWash., that is in­tended to sta­bi­lize the health care mar­kets. “We’re com­mit­ted to mov­ing Alexan­der-Murray,” Thune said.

But by in­sert­ing health care into the tax de­bate, Repub­li­cans risked re­ac­ti­vat­ing op­po­si­tion from the coali­tion of health care groups that helped quash their ear­lier re­peal ef­forts.

On Tues­day, 16 lead­ing con­sumer and pa­tient groups to­gether ex­pressed alarm at the pro­posal. “Re­peal­ing the in­di­vid­ual man­date with­out oth­er­wise in­creas­ing ac­cess to ad­e­quate, af­ford­able health in­sur­ance is a step back­wards for in­di­vid­u­als and fam­i­lies” noted the groups, which in­clude the Amer­i­can Heart As­so­ci­a­tion, the Amer­i­can Lung As­so­ci­a­tion, the March of Dimes, Con­sumers Union and the ad­vo­cacy arm of the Amer­i­can Cancer So­ci­ety.

Democrats called it a des­per­ate move that would re­sult in 13 mil­lion ad­di­tional unin­sured Amer­i­cans and premium hikes of 10 per­cent, ac­cord­ing to non­par­ti­san analy­ses of the im­pact of end­ing the man­date.

“Repub­li­cans just can’t help them­selves,” said Senate Mi­nor­ity Leader Chuck Schumer, D-N.Y. “If the Amer­i­can peo­ple weren’t al­ready out­raged by this (tax) bill, in­ject­ing health care into it will cer­tainly do the trick.”

The House tax bill, which is ex­pected to pass later this week, does not in­clude the Oba­macare pro­vi­sion. Con­ser­va­tives pushed to add it to House leg­is­la­tion.

Senate Repub­li­cans have been fran­ti­cally search­ing for ways to make their bill more at­trac­tive to mid­dle­class tax­pay­ers, while still adding no more to the fed­eral deficit than the $1.5 tril­lion al­lowed un­der their bud­get in­struc­tions.

The tax bill low­ers tax rates for many in­di­vid­u­als, but also does away with pop­u­lar de­duc­tions, such as the abil­ity to write off state in­come and prop­erty taxes, widely used in New York and other high-tax states.

House Repub­li­cans ended up re­tain­ing prop­erty tax de­duc­tions up to $10,000 after law­mak­ers from New York and New Jersey ob­jected.

Some key GOP sen­a­tors also voiced con­cerns that their plan did not do enough to help the mid­dle class. “Mid­dle in­come tax­pay­ers are go­ing to be re­ally hurt by re­peal of the SALT,” said Sen. Su­san Collins, RMaine, us­ing the acro­nym for state and lo­cal tax de­duc­tions.

A some­what sim­i­lar idea, the so-called skinny Oba­macare re­peal, failed to garner enough Repub­li­can sup­port in the Senate last July when Collins joined Sens. John McCain of Ari­zona and Lisa Murkowski of Alaska to vote no.


Sen. John Thune, R-S.D., said a bill to sta­bi­lize in­sur­ance mar­kets will move for­ward.

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