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

Ron Sachs/SIPA/NewscomRon Sachs/SIPA/NewscomThe 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.

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  • Fist of Etiquette||

    But the broccoli mandate still stands, right?

  • Citizen X - #6||

    Broccoliman Date was my username on eHarmony when i was single. I did NOT get a lot of hits.

  • Hugh Akston||

    That's because you punctuated it wrong, dumbass. If you had used Broccoli Man-Date you would have had all the skinny, bearded trim you could handle.

  • BestUsedCarSales||

    So he's both broccoli and a date? You can't be both a fruit and a vegetable!

  • Bubba Jones||

    I don't get it. Are there people who honestly don't understand why a tax bill would be used to repeal a penaltax?

  • NotAnotherSkippy||

    Why Republicans Are Attempting to Repeal the Mandate a Tax with a Tax Bill.

    Fixed that for you.

    And was the NYT as conveniently skeptical about the 22 million who would "lose" health insurance according to the CBO? Didn't think so.

  • WC Varones||

    What's a nice guy like Suderman doing in a cess pool like the NY Times?

  • loveconstitution1789||

    Floating his resume?

  • Domestic Dissident||

    Working exactly where he belongs.

    Maybe if they eventually pay him a little more he can get the fuck out of here and stop pretending that he's a libertarian.

  • BYODB||


    Democrats are warning that to do so would be to undermine the health care law and end coverage for millions.


    This is such a blatant lie it's honestly an indicator of how stupid someone is if they actually believe it.


    Ending a mandate is not causing anyone who wants to keep insurance from keeping it. It simply means that if you don't want to keep insurance you are not forced to do so. Is this not obvious?


    Factually speaking the only reason Democrats are fighting to keep the mandate is because they know that forcing millions of people to bend their knee against their will is the only way to make their preferred policy appear workable.


    Pretty much any media outlet that repeats this flagrant lie is compromised to such an extent that they can't be trusted. Either the reporter is too stupid to do even basic research, or is actively supporting propaganda.

  • BestUsedCarSales||

    I've said it before and I'll say it again. There is no consideration of means, there is only consideration of ends. The ends they want it more people with health care, if that has to come with a gun to their heads then so be it. That's outside of their considerations.

  • BYODB||

    The fact is that Democrats needed a lot of people who didn't want, and didn't need, healthcare to put money into the system against their will (and it's also a fact that this was never going to be enough, but it got the CBO to play nice). Useful idiots went along with it for emotional reasons, like imagery of grandma being thrown out in the streets, but it was never honest.

    The fact that people want to keep the ACA when it is responsible for doing the exact opposite of it's stated intent is proof that no one really gives a shit about results either.

    Or, it's possible the end-results aren't what we were told they are. In fact, this seems like the most likely scenario since everyone knew at the time that the ACA would do exactly what it's done. That isn't a disconnect between intent and action, that's willful action. At best the Democrats and the populace are guilty of wishful thinking and willful ignorance when it comes to actual health care.

  • Knutsack||

    While I agree with this, their argument (I believe) is that, without youngsters being forced to by insurance, people will lose their coverage because of the unstable markets. Companies will pull out once they realize that only sick people will be paying premiums and they will become too costly to insure.

    Dems da breaks, I say, but that's why they're talking about his ending coverage.

  • BYODB||

    True enough, one aspect of their plan was to bilk the young working class to subside healthcare the government promised to the old and no longer working which the government never adequately planned for.

  • ||

    Factually speaking the only reason Democrats are fighting to keep the mandate is because they know that forcing millions of people to bend their knee against their will is the only way to make their preferred policy appear workable.

    And in the current context this isn't totally unreasonable - in fairness, the Republicans are doing what they always do - not actually addressing the spending problems that Democrats get us into, but instead fucking things up further in the name of scoring cheap political points.

    Just as they want to cut taxes without cutting spending, they want to get rid of the individual mandate without getting rid of guaranteed issue.

    This means in effect that there is no such thing as medical insurance anymore. You don't have to buy insurance until you need someone to pay medical bills for you, and they can't turn you down when you do that. Why would anyone who doesn't have ongoing medical expenses want insurance in that case? That means that insurance companies are merely payers, not insurers - they don't manage risk, they simply pay out damages. Where this money is supposed to come from is anyone's guess.

    If the Republicans wanted to fast-track us onto Single Payer, they couldn't have come up with a better way.

  • BYODB||

    Honestly, overall I agree with you but meaningfully there wasn't going to be any kind of real push away from single payer. I had hopes before the Presidential election, but now I'm fairly certain single payer is the inevitable result. I've made that case too many on why that's inevitable, but it still makes me mad.

    I did want to specifically reply to this bit though:

    Just as they want to cut taxes without cutting spending, they want to get rid of the individual mandate without getting rid of guaranteed issue.

    I'm not sure that it matters when guaranteed issue and community rating were already in there, and on their own have already managed to destroy markets, but I won't deny that accelerating that inevitable process will probably get blamed (perhaps rightly) on Republicans. I'm not sure an expedited death for that program is actually a bad thing at the end of the day, but it will be for Republicans.

    I find the odd's at close to zero that most will notice that it was an inevitable result, though.

  • Phos||

    If the mandate is abolished, could ACA be challenged again, because it is no longer a tax?

  • BYODB||

    It could always be challenged again, but if the mandate isn't in the law you couldn't use it as an argument for for why it's unconstitutional.

  • magellannh||

    I get that people hate the mandate and I largely agree that it's not very effective anyway. What I don't understand is why Republicans can't replace the mandate with something that would actually help stop the gaming by free-riders.

    For example, insurers should be able to charge an "early termination fee" if someone who's uninsured stops paying premiums after receiving a bunch of care. It'd be better not to force this fee into the market, but it should at least be allowed. The same is true for letting insurers charge an initiation fee. These don't need to be requirements on insurers, only options for them.

    Who would have guessed that Republicans would control the entire government and the people they would choose to screw over are those of us paying our own way and taking personal responsibility, all the while ensuring the largess continues to flow to folks on the government dole.

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