The new tax bill, passed by the Senate early Saturday, is not just about taxes. It has significant consequences for the American health care system – especially for the most vulnerable of our citizens.
If the proposed tax bill comes to fruition, it will reduce the affordability of health care for many Americans. Without access to care, our sickest and most vulnerable – especially the the poor and elderly – will suffer an increasing chance of poorer health outcomes.
What's more, the bill's long-term outcomes will be bad for our economy, resulting in lost productivity, lost wages and increased health care costs. If Americans become less healthy and have less access to health care, then everyone loses.
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This bill puts much of the health system reforms under the Obama administration in jeopardy. For example, the Senate tax plan includes a repeal of an important part of the Affordable Care Act, the individual mandate. This provision requires that most Americans buy health insurance, or pay a penalty.
Many health care experts see the mandate as the only way to bring healthy people into the insurance marketplaces. Gutting the mandate would result in 13 million more uninsured Americans over the next 10 years.
Additionally, the Senate bill is expected to trigger a US$25 billion annual cut to Medicare, including cuts to cancer care for older Americans covered by Medicare. The House plan also eliminates medical expense deductions, implying that catastrophic expenses will not be as deductible under the new tax proposal.