Arguably the most significant data point in the entire debate about the Senate health care bill has been the CBO’s claim that in 2026, 22 million fewer people would have health insurance under the Senate bill than under Obamacare.
Democrats have seized on this number to stoke fears about the bill’s impact; moderate Republicans, intimidated by the negative headlines, have been reluctant to support the bill.
But buried within the CBO’s reports is a key fact: the vast majority of those coverage “losses” occur because the GOP bills repeal Obamacare’s individual mandate. In its July 20 estimate of the most recent version of the Senate’s Better Care Reconciliation Act, or BCRA, CBO says that in 2018, 15 million fewer Americans will have health insurance under the bill, two years before its repeal of Obamacare’s insurance subsidies takes effect.
Why? It’s “primarily because the penalty for not having insurance would be eliminated.”
. . .
The new Senate health bill abolishes the following Obamacare taxes: 1) Individual Mandate Tax; 2) Employer Mandate; 3) Medicine Cabinet Tax; 4) Flexible Spending Account Tax; 5) Chronic Care Tax; 6) Health Insurance Tax; 7) Medical Device Tax; 8) Tax on prescription medicine; 9) Tax on Medicare Part D retiree prescription drug coverage; 10) Health Savings Account (HSA) Withdrawal Tax; and 11) 10% excise tax on small businesses with indoor tanning services. The Senate bill also delays the “Cadillac” tax on employer-provided insurance until 2026 and doubles the maximum HSA contribution from $3,400 to $6,550 for individuals and from $6,750 to $13,100 for families. The Senate bill also allows Americans to use HSA funds to pay for health insurance premiums.
. . .
The ACA instituted, for the first time in over half a century, a tax on the value of employer-sponsored health insurance, known as the Cadillac tax. This step represented a significant shift in policy that has the potential to affect more than 150 million Americans covered by such insurance. While there are strong justifications for either repealing or reforming the Cadillac tax, policymakers should be apprised of the potential benefits and pitfalls of each approach. In this paper, we review the history of employer-sponsored health insurance and offer three options for replacing the Cadillac tax without returning to the undesirable pre-ACA status quo: 1) Eliminate the Cadillac Tax and the ESI tax exclusion; 2) Eliminate the Cadillac Tax and cap the ESI tax exclusion; and 3) Replace the Cadillac Tax and the ESI tax exclusion with income-based subsidies.
The Congressional Budget Office says 15 million people will lose medical coverage next year if the Senate GOP’s health-care bill becomes law. That’s not quite accurate. CBO doesn’t believe that millions will “lose” their insurance in 2018. Instead, the agency thinks that millions will happily cancel their coverage—even those who get it for free. The reason: The Senate bill would repeal the Obamacare tax penalty on the uninsured, known as the individual mandate. If CBO is to be believed, 15 million people didn’t want health coverage in the first place. They enrolled only to keep the IRS off their backs.
. . .
The Trump administration took another step Wednesday toward deregulating federal insurance exchanges created under the Affordable Care Act.
For coverage in 2018, consumers can buy an ACA-approved plan directly from a broker or an insurer’s website instead of having to go through HealthCare.gov, the CMS announced. The news comes just two days after small businesses were given permission to skip the federal marketplace to sign their employees up for SHOP coverage.
. . .
How many different ways are there to make a Domino’s pizza? The answer might interest you. It might also interest the Food and Drug Administration — at least, it should.
The nation’s franchise restaurants are about one month away from the imposition of new nutritional-labeling rules dreamed up by the Obama administration, another gift of the grievously misnamed Affordable Care Act. For outlets of brands with 20 or more locations, that means posting signs in the shop with calorie counts for every item on the menu and for every variation on that item.
. . .
Business groups were hoping a quick repeal of the Affordable Care Act would give employers more flexibility on health care and create momentum for priorities like a tax overhaul.
Friday’s decision by House GOP leaders and President Donald Trump to abandon a vote on the Republican health plan left them less certain on both fronts.
“This is a dismal failure,” said Juanita Duggan, chief executive of the National Federation of Independent Business, a group representing small businesses. “NFIB is officially unamused, and we’re not going to let them off the hook.”
. . .
The Republican House health-insurance reform bill would replace Obamacare with a more consumer-driven system. Rather than having many provisions take effect in 2020, Congress should pass it soon and make it effective next year. But it is getting attacked from both the right and the left. What’s missing from the news coverage is improvements in the new bill. Here are six:
1. No employer mandate.
2. Refundable tax credits to buy health insurance.
3. Expansion of HSAs and FSAs.
4. Move Medicaid patients to regular coverage.
5. Lower costs for the young.
6. Incentives to keep coverage.
. . .
The shaky case for the individual mandate is based on mistaken premises, faulty economic analysis, short-sighted politics, and flawed health policy. Opponents have found the mandate to be administratively challenging, politically unsustainable, economically unnecessary, beyond the proper role of government, and constitutionally questionable. Arguments in favor of the individual mandate usually present it as a necessary, though far less popular, means to more laudable ends.
. . .
Following an Obama administration order, the IRS had been set to require taxpayers to indicate on line 61 on their form 1040s whether they had maintained health coverage in 2016 or paid the penalty. The IRS would have rejected returns if taxpayers failed to report their coverage status. But the IRS announced this week it would not reject returns that failed to check the appropriate ObamaCare boxes—an early indication of the administration’s efforts to provide relief from ACA mandates.
“This year, the IRS put in place system changes [initiated by the Obama administration] that would reject tax returns during processing in instances where the taxpayer didn’t provide…information [attesting that the taxpayer had health insurance].
“The recent executive order [issued on day one of the Trump administration] directed federal agencies to exercise authority and discretion available to them to reduce potential burden. Consistent with that, the IRS has decided to make changes that would continue to allow electronic and paper returns to be accepted for processing in instances where a taxpayer doesn’t indicate their coverage status.”
. . .