Health Care and the Senate Tax Bill:

At the time of the writing of this newsletter, the Senate had not yet voted on the proposed tax bill, though it appears they have the votes and will vote shortly. Keep in mind that if the bill passes the Senate, it will need to reconciled with the bill that passed the House which has major differences and then that reconciled bill will have to pass in both the House and Senate.

What’s surprising is that the GOP is once again pushing a very complex bill through at high speed without time for analysis or comment. This is major legislation that should be assessed and debated, however that seems to out of style in Washington. Tax reform on it’s own is a lot and for some reason, health insurance was brought into the mix even though multiple attempts to repeal or modify it ultimately failed mostly because of a concern that it avoided the usual legislative process. In terms of health insurance, the tax bill would repeal the Individual mandate which requires almost everyone to either have health insurance or pay a tax penalty. Without the individual mandate, it is estimated by the Congressional Budget Office that 13 million fewer people will have health insurance (about 50% of the current ACA enrollment, premiums would increase by at least 10% for those who continue coverage along with possibly weakening insurer financial solvency. The American Academy of Actuaries shared these conclusions in a letter to Senator McConnell and Senator Schumer. Insurance Commissioners have expressed concerns that this will damage health insurance markets. Medicare would also be impacted as the Congressional Budget Office estimates that the GOP tax bill could spur $25 billion in Medicare cuts and up to $410 billion over ten years. And that’s without worrying about the additional $1 trillion added to the deficit (Congressional Joint Committee on Taxation).

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