As House Republicans weigh reactions to their draft tax-cut bill and make various nips and tucks, there’s one conspicuous issue they are leaving alone at present: the idea of repealing the individual health-insurance purchasing mandate, which the president and many conservatives want to include in the legislation. Here’s how the Washington Post describes the state of play:
The topic didn’t come up much at yesterday’s House Ways and Means tax markup, where Republicans and Democrats instead sparred over the effort to eliminate various deductions, the measure’s impact on low-income people and even a provision allowing parents to set up college savings accounts for their unborn children.
And Ways and Means Chairman Kevin Brady (R-Tex.) — who has previously said he didn’t want to attempt individual mandate repeal as part of the tax effort — didn’t include it among several amendments he proposed to the bill.
But Brady is far from ruling it out:
Brady told radio host Hugh Hewitt Tuesday that he is still considering including mandate repeal in the tax bill, which was being marked up by his committee on Tuesday. Brady said he is expecting an updated score from the nonpartisan Congressional Budget Office on the impact of including repeal.
It is unclear what an “updated” score would accomplish. One provided by the CBO in December of 2016 estimated that a simple repeal of the mandate would save $416 billion in federal spending over ten years, but would also cost 15 million people health coverage and boost individual insurance premiums by 20 percent. This is because repealing the mandate would mean that a lot of healthy people would drop out of the system, making insurance more expensive for many others. $416 billion would be a nice chunk of change to toss into the stew in the current tax bill, helping defray the cost of tax cuts and/or replace revenue-raisers knocked out for political reasons. But there’s an inherent connection between the “good” and “bad” news in the 2016 CBO report — the spending cuts would be produced by people falling out of the Obamacare insurance market, and thus not needing tax credits to pay for it.
It sounds like the CBO will ratchet down its estimates of the impact on both spending and on health insurance:
Could be that Brady not only wants to check the numbers, but also wants to stall a bit to see how badly he needs the money a mandate repeal could produce.
Another variable, of course, is Donald Trump, and not just because he wants congressional Republicans to go back down the rabbit hole of Obamacare-repeal efforts. Trump is also reportedly mulling executive actions that could weaken the mandate, thus saddling the GOP with some of the same adverse effects on the health-care system as a legislative repeal, but without the silver lining of a federal spending cut offsetting Brady’s tax goodies.
Having to revisit Obamacare in a tax bill is probably the very last thing Mitch McConnell wants to do. A nice tax cut for donors and “the base” was supposed to be the dessert Republican senators earned for all of the cod-liver oil they had to consume in two failed efforts to repeal Obamacare. But it’s the Senate whose budget rules require that the tax bill’s math adds up. So if ol’ Mitch wants to stay out of the Obamacare quagmire, he’d better rustle up some more revenue-raisers.