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20 Dec 2017

ObamaCare finally repeals by Congress

The House followed the Senate on Wednesday in voting to repeal ObamaCare's individual insurance mandate, fulfilling a longtime GOP goal targeting the health-care law.

The repeal, which now heads to President Trump's desk, is the first major legislative victory for Republicans to strike down a provision of the law.

Gutting the mandate that Americans buy insurance or pay a tax penalty has been a target of Republicans in every iteration of their ObamaCare repeal bill this year.

The measure was ultimately included in the GOP's tax overhaul, which passed along party lines this week in the Republican-led House and Senate.

“When the individual mandate is being repealed that means ObamaCare is being repealed,” Trump said during a Cabinet meeting at the White House on Wednesday.

“We have essentially repealed ObamaCare, and we will come up with something much better," Trump added, saying block grants might be one approach.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.

The original House bill didn’t include the measure, but Sen. Tom Cotton (R-Ark.) pushed the Senate to include a repeal of the mandate — a core element of former President Obama's signature health-care law — in their tax plan.
The move worked, and the final bill agreed to by GOP lawmakers in a conference committee eliminated the mandate.

Many health-care experts and industry groups expressed concern leading up to the final passage of the tax bill, saying repealing the mandate could hurt the stability of the ObamaCare markets, potentially causing premiums to rise and insurers to drop out of the health-care exchanges.

Without the mandate, the nonpartisan Congressional Budget Office (CBO) estimated that 13 million fewer Americans will have health insurance in 2027 and premiums will rise 10 percent. But it also predicted individual insurance markets will remain stable “in almost all areas of the country throughout the coming decade.”

The individual mandate was included in ObamaCare in part to draw young and healthy people to sign up for insurance in the marketplaces as a way to offset the costs of older and sicker enrollees.

Still, not everyone agrees that the measure has worked as intended, with some saying the mandate hasn’t been as effective as originally thought to entice people to buy health insurance.

“Today, we're turning Obamacare from a mandatory program into a voluntary program and providing additional tax relief for the millions and millions of Americans who have chosen and will choose not to buy a government-mandated product that for them provides not the value that they want,” Sen. John Barrasso (Wyo.), the No. 4 Senate Republican, told reporters on Tuesday.

Republicans voted this week to do away with the mandate after multiple attempts to kill the measure going back years failed, including a turn in front of the Supreme Court, which ruled that the mandate was constitutional in 2012.

On Trump’s first day in office, he signed an executive order broadly permitting agencies to scale back ObamaCare, leading some to wonder if the individual mandate would be weakened. But the Internal Revenue Service has since signaled it would enforce the penalty.

The repeal of the individual mandate provided more than $300 billion in savings for Republicans to use to help pay for the tax bill, the CBO estimated.

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.

But she’s consistently said she’s received assurances that leadership would support two bills she sees as helping offset the repeal: A measure to stabilize the insurance marketplaces from Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) and her legislation with Sen. Bill Nelson (D-Fla.) to provide money to insurers to offset the cost of the chronically ill.

The bills could be included in the Senate’s short-term spending measure to keep the government running past Dec. 22, but will face resistance in the House.

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