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The GOP Passes Tax Bill That Ends ACA Individual Mandate

It took them nearly a year to do it, but 11 months to the day after Donald Trump was sworn in as President, Congressional Republicans finally have their first major legislative “win”. On Wednesday, the House approved the Tax Cuts and Jobs Act (H.R.1) by a vote of 224-201. After public celebrations from The White House and Congressional Republicans immediately following the tax bill's passage, President Trump signed the bill today once Congress waived the $120 billion in PAYGO automatic budget cuts that would have taken place due to the new debt added by the tax bill.

Despite a lack of public support—the tax bill is supported by less than 1 in 4 members of the general public—and the potential effects that might have on the 2018 midterm election Congressional Republicans are thrilled by their legislative victory. In broad outline, Republicans have pushed through a bill that would add $1.5 trillion to the deficit over 10 years due primarily to large tax cuts for high-income households and corporations.

In addition to being a tax bill, the Tax Cuts and Jobs Act is also a health care bill in disguise. In particular, Congressional Republican leadership added in a repeal of the ACA’s individual mandate into the tax bill to partially pay for the cuts. While this move would save an estimated $338 billion over the next decade, it would also result in 13 million fewer people having health insurance over the same time period and 10% increases in premiums in the state marketplaces almost every year for a decade, according to an analysis by the Congressional Budget Office.

This bill, which constitutes the most successful legislative attack on the ACA yet, comes at a time when the health care law has never been more popular among the general public.  It also comes on the heels of a very successful ACA open enrollment period despite the Trump administration’s repeated attempts at sabotage including cutting the overall enrollment period in half and slashing budgets for advertising and state navigators.  Approximately 8.8 million people signed up for health insurance plans compared to 9.2 million last year, a drop of only 4%. In the wake of the bill’s passage through Congress, President Trump declared that, “we essentially repealed Obamacare”, a sentiment that may encourage his Republican base, but which is not born out in reality.

In addition to the very real problems posed by the repeal of the individual mandate, HIV and health care advocates will have to pay close attention to what Congressional Republicans do next, as they have indicated that they are far from finished trying to dismantle health care programs for vulnerable and low-income people. Republicans on Capitol Hill have begun to signal their intent to use the more than $1 trillion that will be added to the federal deficit by their tax cuts to cut vital safety net programs like Medicaid and Medicare. House Speaker Paul Ryan (R-WI) said he intends to “get back next year at entitlement reform”.  AIDS United will continue to work to maintain and even expand Medicaid as one of our top priorities in 2018.  

Posted By: AIDS United, Policy Department - Friday, December 22, 2017

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