GOP to consider ‘skinny’ repeal option on health care
US Senate(WASHINGTON) — The Senate is the middle of thick debate, struggling to pass any option for repealing or replacing the Affordable Care Act (ACA). After a proposal to only repeal the majority of the law failed Wednesday afternoon, Senate sources say the Republican leadership’s next move will likely be to introduce a narrower repeal bill that would only scrap portions of the ACA.
This path, dubbed the “skinny” repeal, as it would be limited in scope, is still in the works. But senators say one possibility would be a bill that only repeals the individual and employer mandates in the ACA as well as the medical device tax.
This approach could leave other parts of the current law intact, including the ACA’s expansion of Medicaid, marketplace regulations about what insurance companies have to cover and what they can charge, and subsidies for people buying their own insurance. GOP lawmakers hope this will increase their chances of passing the bill.
But so far, senators have not proposed specific language for a limited or “skinny” repeal.
“We’re going to figure out from our members what the traffic will bear in terms of getting as much of the Obamacare repeal and other elements into a bill that gets 50 votes,” Sen. John Thune, R-S.D., a member of the Senate GOP leadership, said Wednesday.
Sen. Ron Johnson, R-Wis., indicated he’d vote for a bare-bones package as long as it kept the process moving forward. “We’ll keep the process going. If we’ve got to do something less than obviously I’d want to keep the process going, we’ll do it,” he said.
Under current law, the individual mandate places a penalty tax on those who choose to opt out of insurance plans, while the employer mandate requires companies with a minimum of 50 full-time employees to offer coverage to their workers. The repeal will likely also propose cuts on the current taxes on medical device companies.
Some Republican senators, including Lindsey Graham, R-S.C., said they would not support a vote on any repeal efforts that do not lead to another push to draft a comprehensive replacement option. “We’re trying to find those things that we can agree upon. The main thing to me is a vehicle to do something bigger,” Graham told reporters.
With the individual mandate revoked, more young, healthy Americans may choose to forgo coverage. The Congressional Budget Office (CBO) predicted that just repealing the individual mandate could lead to 15 million fewer Americans having health coverage as opposed to current law. By 2026 they estimate that 43 million people would be uninsured.
Henry Aaron of the Brookings Institution and Urban Institute scholar Robert Reischauer wrote in a Brookings report that this would leave “insurers with a pool of sicker and costlier-than-average customers,” driving companies to increase their premiums in the non-group market. The CBO estimates that premiums would likely jump by 20 percent relative to rates under current law.
This increase in premium costs could lead to some people being priced out of plans they can no longer afford, or the federal government may compensate for these people through subsidies and tax credits.
The individual mandate provides social cost-savers as well. If people don’t have insurance, but still get sick, hospitals, taxpayers, and local governments end up covering the costs. “In the absence of a mandate, those social costs would probably increase relative to the case under current law,” the CBO said in a report last December.
The employer mandate would likely have some coverage consequences, but less than the individual mandate. If passed, a limited repeal could also serve as a placeholder legislation that would allot GOP Senators to plan a more comprehensive replacement to the Affordable Care Act in coming sessions.
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