Statement by National Coalition on Health Care President and CEO John Rother on the repeal of the Affordable Care Act’s individual mandate penalties included in final House and Senate tax legislation
“More than just a tax bill, the legislation before Congress this week would undermine health coverage and affordability in the United States. Repealing individual mandate penalties without replacement would leave millions of Americans without health coverage while doing nothing to address the cost of health care.
“In fact, far from providing relief to health care consumers, enactment of this legislation would saddle Congress and the President with two pressing legislative imperatives.
“First, Congressional leaders will either have to strike a bipartisan, 60-Senate-vote deal waiving the pay-as-you-go law or subject Medicare and its 67 million beneficiaries to $25 billion in automatic cuts next year. That’s a tall order for a Congress that can’t find a way to extend universally-supported children’s health insurance or community health center programs.
“Second, substantial new federal spending will be required to keep private, individually-purchased insurance as a viable option for many – absent the individual mandate. The nonpartisan Congressional Budget Office (CBO) has estimated that the repeal of the ACA’s individual mandate penalties included in the tax bill, would increase premiums in the non-group insurance market by 10 percent and leave 4 million uninsured in 2018 and 13 million uninsured by 2027. Particularly for the middle-income earners or self-employed who receive little or no ACA subsidies, substantial new federal reinsurance dollars will be needed in the short term. Over the long-term, ongoing risk stabilization becomes essential – either through federally-run programs or federally-funded state-run programs. The magnitude of the needed investments dwarf those contemplated under the proposed Collins-Nelson legislation.
“For Congressional leaders and the Administration, these new realities will prove bitter pills to swallow.”