Welp. The Republicans did it. And later today, barring some dramatic last-minute development, the GOP Tax Scam is gonna be signed into law.
UPDATE: It's done. It passed the GOP House, GOP Senate and GOP House (again). Trump's signing it at any moment.
The GOP Tax Scam does many terrible things, of course, many of which are worse than repealing the ACA’s individual mandate. And even within the healthcare arena, the $25 billion PAYGO Medicare cut caused by the GOP tax scam is arguably more damaging overall.
Still, ACA stuff is my wheelhouse, so I’ll stick to the direct impact the bill (if it does become law) would have on the Affordable Care Act.
Above is the video explainer I whipped up a few weeks ago. It’s long and a bit wonky, but it should give a pretty good overview of the situation.
What about the two “market stabilization” bills that Susan Collins was supposedly demanding in return for her “Yes” vote? Yeah, about those:
It's not over yet, since the House of Representatives still has to vote on the bill again (either as is, or after hashing out the differences between the House and Senate versions of the bill), but assuming the final version of the bill includes mandate repeal and is indeed signed into law, this is what the ACA's 3-legged stool would look like when the dust settles.
Obviously I'll have much more to say about what happened last night soon, but for the moment I'll leave it at this.
Collins' bill with Nelson would set aside $4.5 billion over two years to help states establish reinsurance programs. Reinsurance directly compensates insurance carriers for their most expensive customers.
To the best of my knowledge, that's...pretty much all it does: $2.25 billion per year for two years, and then...that's it. If there's more to the bill than that, I'll revise this post, but in the meantime, that seems to be the whole bill.
As part of their Godawful "tax reform" bill, Congressional Republicans have decided to toss repealing of the ACA's individual mandate penalty into the mix, partly because they've always hated it but mainly because doing so would allegedly save the federal government $338 billion over the next decade...which in theory would be enough to keep the total increase in the federal deficit bythe tax bill below the $1.5 TRILLION mark (yes, you read that correctly: $1.5 TRILLION, with a "T").
Before I get into the meat of the headline, I just wanted to point something out (bear with me, there's a reason for this):
October, 2013: Several million people receive cancellation notices from their health insurance companies, stating that their current policies will be discontinued effective 12/31/13 because they don't meet the Affordable Care Act's minimum coverage requirements. Much outrage and gnashing of teeth follows because President Obama had repeatedly stated that "If you like your plan you can keep it" (which, as I noted over a year ago, was an absurd thing for him to promise without including any caveats since there's no way of guaranteeing that the company won't go out of business, leave the state or simply decide to discontinue that policy for their own reasons which may or may not have anything to do with ACA compliance).
November, 2013: In response to the "You Can Keep It" brouhaha, President Obama and the HHS Dept. announce a 1-year (later quietly extended to up to 3 years) "transitional" policy for non-compliant plans. Some states take them up on it; some don't.
July, 2015: Republicans and other ACA critics complain that allowing the "transitional" policy extension is partly to blame for significant rate hikes expected to show up in 2016.
CONCLUSION: Damned if you do, damned if you don't.