Republicans are right to want to repeal the mandate that fines Americans who don’t buy health insurance. Their dual motive is to repeal the most loathed part of the Affordable Care Act as well as to make tax reform comply with the Senate Byrd Rule that dictates no deficits outside a 10-year budget window. Some Americans no doubt would decide not to buy insurance if they aren’t hit with a tax, but that would be their choice. Republicans aren’t denying them anything. No other ObamaCare rule or mandate would be changed, and no benefit formula would be altered. Anyone who still wants an ObamaCare policy could still buy it.

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Senate Republicans have added the repeal of Obamacare’s individual mandate to the latest version of their tax bill, with several key swing votes saying they’re open to the idea.

Late on Tuesday, the chairman of the Senate Finance Committee, Orrin Hatch of Utah, released a new bill that would eliminate the mandate’s fines beginning in 2019. The addition was discussed at a closed-door party lunch meeting earlier in the day, and several Republican senators said no one spoke out publicly against repealing the mandate.

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Bishop Frank J. Dewane of Venice, Florida, Chairman of the U.S. Bishops’ Committee on Domestic Justice and Human Development, issued a statement in June about a discussion draft of health reform legislation that was then before the Senate, the Better Care Reconciliation Act.  He praised its life protections: “The Bishops value language in the legislation recognizing that abortion is not health care by attempting to prohibit the use of taxpayer funds to pay for abortion or plans that cover it. While questions remain about the provisions and whether they will remain in the final bill, if retained and effective this would correct a flaw in the Affordable Care Act by fully applying the longstanding and widely-supported Hyde amendment protections. Full Hyde protections are essential and must be included in the final bill.”

The leadership in the Senate, the House, and the White House know that any future health reform legislation must contain these strong life protections.

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Last night, Sen. Orrin Hatch (Utah) announced that the Senate Republican tax reform bill would include a repeal of Obamacare’s individual mandate. Why is this a big deal? It all goes back to the profound impact of Congress’ official fiscal scorekeeper, the Congressional Budget Office.

The single most important reason that Republicans failed to replace Obamacare in 2017 is because of estimates by the Congressional Budget Office that 22 million fewer people would have health insurance in 2026 under the GOP bills.

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Medicaid spending and enrollment has skyrocketed in recent years, crowding out resources for all other state priorities. The number of people dependent on Medicaid has more than doubled since 2000, with nearly 75 million individuals currently enrolled in the program. Nowhere is this growth more evident than among able-bodied adults. Nearly 28 million able-bodied adults are now dependent on the program, up from fewer than 7 million in 2000.

This enrollment explosion is fueling a massive spending surge. Total Medicaid spending has nearly tripled since 2000 and spending on able-bodied adults has increased by a jaw-dropping 700 percent.

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Vice President Mike Pence is exerting growing influence over the American health care system, overseeing the appointments of more than a half-dozen allies and former aides to positions driving the White House’s health agenda.

On Monday President Donald Trump nominated Alex Azar, a former Indianapolis-based drug executive and longtime Pence supporter as HHS secretary. If confirmed, Azar would join an Indiana brain trust that already includes CMS Administrator Seema Verma and Surgeon General Jerome Adams. Two of Verma’s top deputies — Medicaid director Brian Neale and deputy chief of staff Brady Brookes — are former Pence hands as well, as is HHS’ top spokesman, Matt Lloyd.

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The tax-reform bill that Senate Republicans are releasing Thursday does not repeal ObamaCare’s individual insurance mandate, though the provision could be added down the line, GOP senators said.

Senators leaving a briefing about the legislation said repealing the mandate is not in the initial text of the legislation, but cautioned that the issue is still under discussion.

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The Senate GOP tax bill will retain a key deduction for qualified medical expenses that was excluded from the House version, according to a Republican senator on the Senate Finance Committee.

Sen. Bill Cassidy (R-La.) told reporters that the deduction will remain in the initial version of legislation the Senate is set to unveil today. “I think there’s always a sense that it’s a good thing to continue,” Cassidy said.
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If you were deliberately trying to design the most arbitrary, painful and pointless tax possible, how would you go about it?

First, you would structure it to inflate the cost of an essential product. Then, you’d create exemptions so vast that only 5% of taxpayers were subject to it. You might even ensure that it hit people only when they were particularly vulnerable—like when they’d lost a job. Finally, you would use it to drive enrollment in entitlements, so that it increased the federal deficit by $338 billion.

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Republicans in Congress are plowing ahead on tax reform, and one obstacle is the complexity of Senate budget rules that limit how much taxes can be cut. The good news is that for once Washington’s fiscal fictions could be deployed to improve policy by repealing ObamaCare’s individual mandate as part of tax reform.

The Senate Finance Committee on Thursday released the details of its tax proposal, which includes a permanent 20% corporate rate and more. Senators Pat Toomey and Bob Corker cut a budget deal to allow for $1.5 trillion in net tax cuts over 10 years without accounting for faster economic growth (and more revenues) as a result of reform.

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