“Just like the health care vote, there were a small number of Republican senators who seemed like they might hold out. But unlike last time, Senate leadership managed to successfully cut deals with these senators to secure “yes” votes.
…Collins was most concerned about the provision in the tax bill that would kill Obamacare’s individual mandate and cause millions to lose their health insurance, according to the nonpartisan Congressional Budget Office….. Collins got Senate leadership to commit to Obamacare stabilization. This ultimately ensures the federal government keeps paying for cost-sharing subsidies to help lower the cost of health insurance, but it won’t do much to mitigate the loss of the individual mandate….
Collins’s health insurance deal has a rocky path forward…
But there’s a major roadblock to Collins’s health care goals: House Republicans.
Republicans in the House have said that Collins made her negotiations with Senate leadership, not them. And they’re clearly feeling no obligation to play by her rules.” (A)
A major obstacle to passing a short-term spending bill by the end of the week was eliminated Wednesday when two key Republican senators asked GOP leaders not to consider health-care legislation as part of the legislation.
Senate Republican leaders had considered attaching the health-care proposal to the short-term spending bill to keep the government running through mid-January. But that approach ran into resistance from hardline conservatives in the House, who balked at approving what they consider a giveaway to insurance companies.
“Rather than considering a broad year-end funding agreement as we expected, it has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs,” Sens. Lamar Alexander of Tennessee and Susan Collins of Maine said in a joint statement.
For that reason, Alexander and Collins said, they asked Senate Majority Leader Mitch McConnell not to offer the health care legislation this week. The senators said they would offer the bill early next year.” (B)
““When the individual mandate is being repealed that means ObamaCare is being repealed,” Trump said during a Cabinet meeting at the White House on Wednesday.
“We have essentially repealed ObamaCare, and we will come up with something much better,” Trump added, saying block grants might be one approach.
During a House floor speech Tuesday, Speaker Paul Ryan (R-Wis.) cast the mandate repeal as “finally restoring the freedom to make your own health-care choices.”
“By repealing the individual mandate at the heart of ObamaCare, we are giving back the freedom and the flexibility to buy the health care that’s right for you and your family,” he said….
Sen. Susan Collins (R-Maine) has aired concerns about repealing the mandate, saying she wished the tax bill left health care alone, while reiterating that she has never actually supported imposing the tax penalty for those going uninsured.
“Repealing the individual mandate without other health-care reforms will almost certainly lead to further increases in the cost of health insurance — premiums that are already too expensive under the [Affordable Care Act],” Collins said in a floor speech Monday where she announced her support for the tax bill.” (C)
“The mandate, which requires most Americans to get health insurance or pay a fine, is repealed in the GOP tax bill. But that does not mean the entire law is being repealed.
The infrastructure for the individual insurance exchanges, such as Healthcare.gov, remain in place.
The expansion of Medicaid under the ACA, which helped cover an additional 15 million people, remains in place in the states that have opted to expand the program.
Other policy changes from the law, such as insurance companies’ inability to reject a patient due to a preexisting condition and mandatory coverage of basic health needs like prescriptions, remain in place.
In fact, according to the Congressional Budget Office, the Obamacare individual insurance markets are likely to remain relatively stable — albeit with a lower enrollment total — even without the mandate.
But the mandate repeal could still bring about adverse affects on the healthcare market.
The CBO estimated that 13 million more people would go without insurance by 2027 without the mandate than if it remained in place. It also estimated that premiums in Obamacare markets would jump 10% over the current baseline.
Most consumers will be shielded from the increase due to subsidies from the federal government, but as many as 2 million Americans could be priced out of insurance, according to the CBO.” (D)
“Ultimately, repealing Obamacare’s individual mandate would cause 13 million fewer Americans to be insured in 2027 compared with current law, according to the nonpartisan Congressional Budget Office (CBO). Healthier and wealthier people may choose to forgo coverage, and even poorer, medically needy people may not sign up for insurance because they don’t know which options are available and there may not be the same sense of urgency to enroll without the mandate. The CBO also predicts that premiums in the markets would spike 10% without Obamacare’s individual mandate as the exchanges are left with a sicker consumer pool. However, for most Obamacare enrollees (those making between 100% and 400% of the Federal Poverty Level), an accompanying increase in federal subsidies will make up for higher premiums. Those making above that income level (about $48,000 for an individual or $98,000 for a family of four) will have to face the brunt of premium increases, though. (E)
(A) Key senators sold their votes on the tax bill for some high-risk deals, by Ella Nilsen, https://www.vox.com/2017/12/20/16796670/gop-tax-bill-flake-collins-immigration-health-care
(B) Alexander-Murray health care proposal delayed, removing obstacle to avoiding government shutdown, by Michael Collins, http://www.tennessean.com/story/news/politics/2017/12/20/alexander-murray-health-care-proposal-delayed-removing-obstacle-avoiding-government-shutdown/970413001/
(C) Congress repeals ObamaCare mandate, fulfilling longtime GOP goal, RACHEL ROUBEIN, http://thehill.com/policy/healthcare/365785-congress-repeals-obamacare-mandate-fulfilling-longtime-gop-goal
(D) Trump applauds ‘Obamacare repeal’ in the tax bill — but there’s a big problem with that claim, by Bob Bryan, http://www.businessinsider.com/trump-obamacare-individual-mandate-repeal-in-tax-reform-bill-2017-12
(E) The GOP Tax Bill Repeals Obamacare’s Individual Mandate. Here’s What That Means for You, by SY MUKHERJEE, http://fortune.com/2017/12/20/tax-bill-individual-mandate-obamacare/