“..the compromise tax bill from House and Senate negotiators will end the health law’s requirement that all individuals buy insurance or pay a fine….”

Doing so could jeopardize Obamacare’s already-shaky marketplaces, by reducing the number of healthier people who sign up for insurance.
The bill will “repeal Obamacare’s individual mandate tax, delivering relief to low- and middle-income Americans who have struggled under an unpopular and unworkable law,” the Kentucky Republican said in an emailed statement.” (A)

“Susan Collins believes, or claims to believe, that Paul Ryan can be trusted to protect Medicare. She thinks that seniors and Americans with disabilities who rely on the program’s benefits should trust him too. That requires ignoring everything that Ryan has ever said about Medicare…
Not only is Collins insisting that Ryan is to be trusted, and can deliver the votes, when it comes to protecting Medicare. She is showing the same gullibility — or hypocrisy — with respect to the health care of those not yet of Medicare age. The tax bill she voted for would repeal the individual mandate, an essential provision of the Affordable Care Act. That would result in 13 million people losing their insurance coverage. For those who still remain in the ACA marketplaces, premiums would go up by an average of ten percent.
But Collins claims that these harms will be mitigated because Congress will separately pass the Alexander-Murray agreement to stabilize the marketplaces. Why is she so sure they will pass it? McConnell and Ryan promised…and of course, they would never go back on their word. If they are so willing to pass it, why didn’t they do so already as part of the just-passed extension of the continuing resolution? A different vehicle will make passage even harder” (B)

“To assume that Collins was “duped” into voting for the tax bill requires thinking that she is profoundly stupid. She might be, but I don’t think she is. An alternate analysis is that Collins is not naive; that she knew all along that McConnell’s promises were worthless; and that she simply wanted a reason to justify (to constituents or to herself) voting for the tax bill. Vote for the bill, then perform disappointment when McConnell pulls the rug out from under you or the House refuses to even consider the “deal” you claim you were promised. Bada-bing, bada-boom….
Susan Collins is not an innocent bystander to the country’s destruction by her party, and it’s time for political commentators to stop treating her as such. Susan Collins is a centrist in today’s Republican Party, which is to say she surpasses the lowest possible bar for basic human decency that exists. Susan Collins is a moderate Republican in the same way that your Aunt Sue is your favorite aunt by default, because at least Aunt Sue doesn’t drink too much chardonnay and tell you the HPV vaccine is going to kill you.
If I had to bet, I’d say Susan Collins will vote for the final version of the tax bill, knowing full well that most of her constituents in Maine would detest it if they knew all its grisly details. I hope she proves me wrong.” (C)

“What happens if the Obamacare death spiral occurs?
The future of the health insurance market, and of President Obama’s signature legislation, is decidedly uncertain. If Republicans make no further changes during the remaining three years of President Trump’s term, the exchanges may limp along, and the Obamacare market may essentially become an expensive, high-risk pool in which insurers offer costly coverage and the government pays ever-increasing subsidies to cover rising premiums.
Or the death spiral may be used as a pretext to repeal the law entirely, throwing the insurance market into further chaos unless a replacement plan is put in place.
Those buying policies on the open market may wish to consider investing in a health savings account so they at least have pre-tax funds available to pay for healthcare expenditures in case the insurance market is upended and the disruption causes a temporary gap in coverage.” (D)

“A group of insurance experts is warning Congress against repealing ObamaCare’s individual mandate, saying the move would raise premiums and could cause insurers to drop out of the market.
The American Academy of Actuaries wrote to congressional leaders on Tuesday saying that “eliminating the individual mandate would lead to premium increases…
The insurance experts also say that a measure pushed by Sen. Susan Collins (R-Maine), intended to help offset the premium increases from repealing the mandate, would not be enough to make up the difference.
That bill, sponsored by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), would fund key ObamaCare payments known as cost-sharing reductions. The actuaries say the payments “would not offset premium increases due to an elimination of the mandate…”
“Insurers would likely reconsider their future participation in the market,” the actuaries write. “This could lead to severe market disruption and loss of coverage among individual market enrollees.” (E)

“House conservatives are launching a full-court press to preserve a key provision rolling back ObamaCare in the final tax-reform bill being crafted behind closed doors by congressional negotiators…
“ObamaCare’s coercive individual mandate represents perhaps the worst example of the federal government violating individual freedom and liberty — which is why we have repeatedly promised to repeal it,” Walker and 70 other committee members said in letter to lead negotiators Texas Rep. Kevin Brady and Utah Sen. Orrin Hatch. “We urge you to help fulfill our promise to the American people and include this language in a final conference package.”
Repealing the mandate would at least give Republicans a significant victory toward the larger goal of a full repeal-and-replace….
The president wants a final GOP tax plan on his desk before Christmas.” (F)

“Ms. Collins remained respectful and strained to convince the room of about a dozen skeptics that the promises that had been made to her were ironclad.
She defended her decision in the face of the group’s challenges that previous Republican promises for the tax bill had been broken, including a commitment to not add to the deficit and to not benefit the rich, and that written agreements are not law.
“I do not believe that I’ve given up leverage,” Ms. Collins said. “I’ve used my leverage to negotiate agreements that are promises to me.”” (G)

(A) GOP Tax Compromise Would Repeal Obamacare’s Individual Mandate, by Zachary Tracer, https://www.bloomberg.com/news/articles/2017-12-13/obamacare-coverage-requirement-undone-in-gop-tax-compromise
(B) Will Susan Collins Save Medicare?, https://www.huffingtonpost.com/entry/will-susan-collins-save-medicare_us_5a317543e4b06a512dd69cdf
(C) Susan Collins Isn’t Being Duped Into Anything, by Emma Roller, https://splinternews.com/susan-collins-isnt-being-duped-into-anything-1821188722
(D) What Is the Obamacare “Death Spiral” — and Can It Be Stopped?, http://www.foxbusiness.com/markets/2017/12/10/what-is-obamacare-death-spiral-and-can-it-be-stopped.html
(E) Actuaries warn of premium increases from repealing ObamaCare mandate, by PETER SULLIVAN, http://thehill.com/policy/healthcare/364514-actuaries-warn-of-premium-increases-from-repealing-obamacare-mandate
(F) Conservatives fight to keep ObamaCare mandate repeal in tax bill, by Joseph Weber, http://www.foxnews.com/politics/2017/12/12/conservatives-fight-to-keep-obamacare-mandate-repeal-in-tax-bill.html
(G) Last-Ditch Effort to Sway Senator on Tax Bill Involves Personal Pleas, by ALAN RAPPEPORT, https://www.nytimes.com/2017/12/14/us/politics/susan-collins-tax-bill.html?_r=0

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