Obamacare

Why Republicans Are Attempting to Repeal the Mandate With a Tax Bill

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Ron Sachs/SIPA/Newscom

The GOP tax bill is now also a health care bill, sort of.

Yesterday, Sen. Rand Paul (R-Ky.) announced that he would push for the Senate tax bill to include a repeal of Obamacare's individual mandate, which requires everyone to maintain insurance coverage that meets government standards or pay a tax penalty.

By the end of the day, Senate Republicans had stuffed a provision repealing the mandate into the bill—which rather conveniently reduces the deficit, according to the Congressional Budget Office, and helps offset the budgetary effects of the tax legislation.

This isn't the first time the mandate has been in the news this year. At the beginning of 2017, the IRS said it would go easy on tax returns that were silent on health coverage, a decision it recently reversed. President Trump has pushed for Republicans to include a repeal of the mandate in the tax bill on several occasions. And of course, there was also that whole effort to repeal—or at least rewrite—and replace Obamacare that took up so much congressional effort throughout the spring and summer.

In today's New York Times, I look at the sometimes tangled history of the debate over the mandate and why Republicans are now taking this particular approach to scrapping the penalty. Here's how it starts:

Seven and a half years after the passage of the Affordable Care Act, and five years after the Supreme Court gave its central provision a stamp of legal approval, America is still fighting over the individual mandate. The debate over the requirement to maintain health coverage or pay a penalty has become a permanent feature of American political life — a debate from which we seemingly cannot escape.

At the moment, much of the debate revolves around the mandate's potential impact on tax reform: Senate Republicans, prodded by President Trump, will include a repeal of the mandate in their tax legislation. Mr. Trump, meanwhile, is reportedly at work on an executive order to weaken the mandate if Congress does not take action.

Democrats are warning that to do so would be to undermine the health care law and end coverage for millions. The accuracy of the Congressional Budget Office model estimating the provision's cost and coverage effects is a major point of contention.

To the sort of casual observer who is blessed to not follow legislative markups and daily Twitter skirmishes over C.B.O. scores, these debates might look both predictably partisan and boringly technical — and often they are. But they also serve as recurring reminders of the many ways in which the mandate has inserted itself into our national political consciousness, its ripple effects touching not only health care but also tax legislation and federal debt and deficit calculations.

Why has the mandate become so central to our politics? And why has the debate about it persisted with such intensity?

Read the whole thing here.