The GOP’s new tax bill, which passed Congress on Wednesday afternoon after one last vote in the House of Representatives and will be signed by President Donald Trump, is also a health care bill. The tax bill does at least as much (if not more) to upend Obamacare, or the Affordable Care Act, than even all of the Trump administration’s thousand cuts to the health law over the past year by repealing the individual mandate. Which raises the question: Just what is the Obamacare individual mandate? And what does its repeal mean for Americans?
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When the authors of the Affordable Care Act promised to “bend the cost curve” in health care, it was typical Washington doublespeak. Voters likely heard those words as a promise that costs would go down, but the intended meaning was merely that they would rise more slowly than before.
Yet even by that meager standard, ObamaCare is a failure. Costs are rising faster than before, and there’s no real prospect of a reversal. The key provisions of the law that were supposed to produce savings and efficiencies either haven’t worked or will never be implemented.
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This study analyzes the 2018 premium increases for health insurance plans offered on the Affordable Care Act’s individual marketplaces. Specifically, it compares the 2018 premiums to the 2017 premiums by analyzing the cost changes in three different plan types by rating area: benchmark Silver, lowest-cost Bronze, and lowest-cost Gold plans. It finds:
- Benchmark plans from 2017 that are still offered in 2018, even if not as the benchmark, rose by an average of 29 percent—the highest average increase since the ACA began;
- Only 17 percent of all rating areas have the same benchmark plan as 2017;
- The average 2018 benchmark plan premium is 36 percent higher than the average 2017 benchmark plan; and
- The lowest-cost Bronze premium and the lowest-cost Gold premium both increased on average by about by 20 percent.
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Senate Republicans are looking for ways to ensure that two ObamaCare funding bills they’re trying to pass don’t put money toward insurance plans that cover abortions.
“There were some questions that were raised in the pro-life community, and we want to make sure we get those addressed so that all conservatives feel comfortable voting for this transition out of ObamaCare, which is what this is all about,” said Sen. Mike Rounds (R-SD).
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Senate Republicans are punting two ObamaCare bills into next year as lawmakers scramble to avoid a government shutdown. GOP Sens. Susan Collins (Maine) and Lamar Alexander (Tenn.) said they have asked Senate Majority Leader Mitch McConnell (R-Ky.) to not bring the bills up this week.
“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. For this reason, we have asked Senator McConnell not to offer this week our legislation,” they said in a joint statement.
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Democrats won a wave election in Virginia a month ago, not only winning the gubernatorial race but at least coming close to taking control of the legislature. Recounts are continuing in three races that could put Republicans in the minority, an astounding defeat for a party that assumed that they could maintain their position by doubling down on Donald Trump. Ralph Northam arguably has a broad mandate to pursue the Democratic agenda in the Old Dominion, but he tells the Washington Post that he wants to de-escalate the bitter partisanship first.
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Speaker Paul Ryan and Senate Majority Leader Mitch McConnell are about to lock horns over Obamacare — part of a House-Senate clash that needs to be resolved by Friday to avert a government shutdown.
McConnell promised moderate GOP Sen. Susan Collins of Maine that he would prop up President Barack Obama’s signature health law in a must-pass, year-end spending bill — so long as she backs tax reform. But Ryan’s more conservative conference is flatly rejecting that idea and urging the Wisconsin Republican to stand firm against his Senate counterpart.
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The individual mandate repeal actually doesn’t take effect until 2019, Laszewski noted, “but I doubt many consumers knew that when they decided not to sign up during all of the news reports about the individual mandate being repealed.”
Thomas Miller, JD, resident fellow at the American Enterprise Institute, a right-leaning think tank here, sees the repeal as “more of a ‘mercy killing’ (putting it out of its chronically ineffective and unpopular misery),” he said in an email. As to whether more people will become uninsured if the mandate is repealed, “Self-serving claims by insurance sector interests and diehard ACA defenders that mandate repeal will trigger widespread disruption and despair in health care markets are vastly exaggerated, as long as other coverage subsidy dollars from taxpayers keep flowing. Good riddance to a half-hearted effort at trying to coerce some mostly less-affluent Americans into buying coverage they did not want, could not afford, or both.”
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Calls to fund CSRs and other payments to insurers in 2018 are rooted partly in a fundamental misunderstanding of why Obamacare premiums continue to rise. Although premium increases are to some degree attributable to the Administration’s cancellation of CSR payments, premium increases were considerable even for policies unaffected by the Administration’s decision.
Lavishing billions of federal dollars on the insurance industry in 2018 is misguided policy. Insurers have secured another round of rate hikes and, with them, billions more in federal premium subsidies. Nor are federal dollars necessary for a state to operate a successful risk-mitigation program, as Alaska has shown.
Trying to rush CSR and reinsurance payments out the door in 2018 will result in wasteful and unnecessary spending, and is more likely to create confusion than to produce the predictability lawmakers seek.
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Some Americans will be given several extra days to sign up for Obamacare insurance plans after the federal enrollment period officially ends Friday, amid long waits on the government’s enrollment phone line.