32 Million People Would Lose Coverage If Obamacare Was Repealed

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Obamacare's individual mandate can't catch a break.

The requirement that all Americans purchase health insurance was at the center of the first major battle over the Affordable Care Act: a Supreme Court case over whether it was legal to mandate the purchase of private health insurance.

The individual mandate survived that battle but now is at the center of another big fight, this one about tax reform. We >learned late yesterday

that Senate Republicans intend to add a repeal of the individual mandate to their tax bill.

There are two key reasons to do this.

First, repealing the mandate saves the government money. The Congressional Budget Office estimates that not requiring Americans to carry health insurance coverage would reduce the deficit by $316 billion over the next decade. (This is mostly because fewer people would participate in government health insurance programs, so less money would flow to subsidizing those programs.)

As Vox's Dylan Matthews and Tara Golshan write, the individual mandate repeal and other changes were made to the Senate tax bill to "ensure the new plan complies with the 'Byrd rule' of Senate procedure. Senators can’t pass legislation that increases the long-run (traditionally defined as 10-plus years into the future) deficit through the budget reconciliation process, a process that enables senators to evade the filibuster and pass bills with only 51 votes (or 50 plus Mike Pence)."

Repealing the individual mandate creates more space to pursue larger tax cuts in this current reform effort.

Second, the individual mandate is unpopular. The Kaiser Family Foundation released >a new poll

Wednesday finding that 55 percent of Americans support the idea of repealing the individual mandate.

That number rises to 73 percent when you look at the respondents who identify as Republican.

What's more, the individual mandate often polls as the most unpopular part of Obamacare. The law's ban on preexisting conditions and requiring insurers to cover young adults on their parents' plans through age 26 typically get high marks. But it's notable that even 38 percent of Democrats in the Kaiser poll say they'd be supportive of repealing the individual mandate.

Charging Americans a fine for not buying health insurance, unsurprisingly, isn't a big political winner.

But this doesn't mean the politics of individual mandate repeal are easy. Repealing the individual mandate isn't a standalone decision. Multiple analyses expect that premiums would increase and millions would lose coverage if this part of Obamacare went away.

The reason is clear: When there isn't a requirement to purchase health coverage, those with few health conditions may decide to skip insurance. They would leave the market, not paying premiums if not required to do so.

This would leave a sicker population behind. Those people would end up with higher premiums. Some of the people who did want insurance would ultimately get priced out of the market as premiums rise higher and higher.

The Congressional Budget Office estimates that 13 million Americans would lose coverage if Congress repealed the individual mandate. That figure actually does a lot to sway public opinion about whether repeal is a good idea.

The Kaiser poll shows what happens when people are asked whether individuals support repealing the individual mandate. They then followed up with a second question, about whether their opinion would change if they heard that it would increase the number of people without health insurance by 13 million over the next year.

Support for mandate repeal dropped by 17 percentage points after hearing that fact.

This has always been the challenge of individual mandate repeal for Republicans. While the idea polls well initially, it has real-world consequences. Headlines about millions of Americans losing health insurance are really hard to contend with — as we saw in the Obamacare repeal fight earlier this year.

But you can't separate the two. Repealing the individual mandate has big consequences, and Republicans will need to decide if they are ready to face them.

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Source : https://www.vox.com/policy-and-politics/2017/11/15/16658092/tax-reform-became-obamacare-repeal

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