WASHINGTON — The House of Representatives approved the landmark GOP tax reform bill that eliminates, starting in 2019, a key provision of the Affordable Care Act (ACA) — the penalty for individuals not buying health insurance. President Trump is expected to sign the bill quickly.
An earlier version had passed the House on Tuesday, but it turned out to violate Senate rules and had to be tweaked. The altered bill passed the Senate earlier on Wednesday and the House voted again in support. The final tally in the re-vote was 224-201, with 12 Republicans voting against the measure and no Democrats voting in favor.
At this writing, Trump had posted several tweets about the bill on Wednesday, congratulating Congress on passing it, but he made no specific mention of the individual mandate repeal.
Experts from both left and right on the political spectrum have predicted that ending the so-called individual mandate will lead millions to drop health insurance, though they disagree on whether that will be good or bad for the country. Conservatives have argued that the mandate unfairly penalized people for not buying insurance they don’t want or can’t afford; liberals have contended that it will be mostly younger, healthier people who choose not to buy insurance, causing premiums to soar for those who can’t afford not to have it.
At bottom, the issue is how the per-capita $10,000 cost of healthcare in the U.S. should be paid for — and in particular, to what extent those with lesser projected healthcare needs should help subsidize those who are needier.
Trump and congressional Republicans have vowed that repealing the individual mandate is only the first step in dismantling the ACA. Even before the tax reform bill passed in the Senate, senators Lindsey Graham (R-S.C.) and Bill Cassidy, MD (R-La.) were talking up plans to revive their repeal-and-replace bill in 2018, Politico reported.