Senate Republicans are set on repealing the Affordable Care Act (ACA) individual mandate as part of their tax bill. The move would save the government money (a reported $316 billion over the next decade) and pave the way for massive corporate and high-income tax cuts.
The mandate, which says Americans must buy health insurance or pay a tax penalty, is paramount to keeping the ACA afloat. It gives healthy Americans an incentive to buy health insurance. If only people who are sick — and therefore expensive to insure — buy health insurance, insurers must hike premiums or stop offering plans, which prices both sick people and healthy people out of the market. Some 13 million people are projected to lose coverage as a result of overturning the individual mandate.
And, so, the proverbial death spiral Republicans have long cited as one of their many reasons for the law's repeal begins.
But to shore up crucial swing votes for the tax bill, Republicans might try something new: Pass bipartisan health care legislation — specifically a bill negotiated by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash, — in tandem.
The bill attempts to stabilize health insurance markets by easing state innovation waiver requirements and mandating cost-sharing reduction payments (CSRs), which President Donald Trump stopped making to insurers in October.