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Senate Republicans to Add ACA Mandate Fight to Tax Fight

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Senate Republicans are adding an Affordable Care Act (ACA) individual mandate repeal provision to their version of the big tax bill, the Tax Cuts and Jobs Act bill, Republican senators said today in Washington.

Democratic members of the Senate Finance Committee, the committee now marking up the bill, looked at articles about the coming rewrite of the bill on their cell phones today at the markup. They repeatedly asked Sen. Orrin Hatch, R-Utah, the chairman of the committee, whether news reports about the rewrite were true.

Hatch declined to say what will be in the rewrite, and he said discussions about ACA mandate repeal were a distraction from the committee’s work.

(Related: GOP Senator Floats Repealing ACA Individual Mandate in Tax Bill)

“We’re still working to finalize the details of the modification,” Hatch said.

Hatch said drafters will release the modification “later today.”

Sen. Ron Wyden, R-Ore., the highest ranking Democrat on the committee, asked Hatch whether “later today” meant 10 p.m., midnight or some other time.

“You’ll have it later today,” Hatch said. “Whenever we can get it done.”

Hatch said that members of the committee would have to time review the modification, and that the committee will begin considering the modification at 9 a.m. EST tomorrow.

The committee began marking up the tax bill Monday and continued to mark it up today. The committee has been streaming live video of the markups from its website.

A video recording of the second of the markup is available here

A link to the live video stream for tomorrow’s session is available here.

The ACA individual mandate requires many people to have what the government classifies as solid major medical coverage throughout much of the year or else pay a penalty. For the people who pay the penalty, the penalty for 2017 will amount to 2.5% of “modified adjusted gross income” over the tax filing threshold.

Sen. Ron Wyden, R-Ore. (Photo: AP)

Sen. Ron Wyden, R-Ore. (Photo: AP)

Republicans have been talking about the possibility of adding an individual mandate repeal provision to the ACA for weeks. President Donald Trump tweeted a request for Congress to ACA mandate repeal to the tax bill on Monday.

Wyden argued at the markup that adding an individual mandate repeal provision to the tax bill is a major change to the bill.

“This is now a major health care bill,” Wyden said.

Wyden said Hatch should at least give committee members 24 hours to propose health care amendments to the tax bill.

“I apologize to every member of the committee,” Hatch said of the timing. “But this is the way it is.”

Sen. Pat Toomey, R-Pa., said Democrats can propose health-related amendments, even without an extra health amendment filing extension, by changing the text of amendments they have already submitted.

The Senate tax bill includes major life insurance tax provisions. Committee members did not focus on those provisions today, and it’s not clear whether the new modification would affect the life provisions.

The Mandate Fight

Some players in health insurance have argued that the current individual mandate is so lightly enforced that it has no real effect and is not worth trying to save.

America’s Health Insurance Plans and the Blue Cross Blue Shield Association are part of a coalition that’s fighting to save the mandate. Those groups teamed up with the American Academy of Family Physicians, the American Hospital Association, the American Medical Association and the Federation of American to Hospitals to write a joint letter asking congressional leaders to keep the mandate in place.

“If Congress simply repeals the mandate while leaving the insurance reforms in place, millions more will be uninsured or face higher premiums, challenging their ability to access the care they need,” the groups write in the letter.

Alexander Minicozzi, an analyst at the Congressional Budget Office, that, if the individual mandate has been working, it’s possible that some of the benefits of the mandate could remain, even if the current legal requirement goes away.

It’s possible, for example, that what consumers have learned about health benefits and enrollment as a result of the Affordable Care Act, and the individual mandate, would continue to push up overall enrollment levels even if Congress repealed the mandate, Minicozzi suggests in a new presentation slidedeck

—Read Scott Kicks Off Battle Over Senate Tax Bill Life Provisions on ThinkAdvisor.

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