Tax Bill's Repeal of Individual Mandate Big Loss for Health Care
(Bloomberg View) -- In its failure to repeal Obamacare this fall, Congress should have learned a simple lesson: Americans want the government to see that everyone has health insurance. Instead, the Republican majority tirelessly insists on moving in the opposite direction. Thus, their shambles of a tax bill repeals Obamacare's requirement that everyone have health insurance.
Keep in mind that, in the U.S., the private insurance market is the mechanism that shares out the cost of health care. The premiums that people (and their employers) pay create pools of money used to finance care. The Affordable Care Act makes this mandatory: Everyone must have insurance -- whether it's an individual policy, one provided through an employer, or a public benefit such as Medicaid or care provided by Veterans Affairs -- or pay a tax penalty.
People may resent being told to buy something. But if they don't buy health insurance, premiums rise for those who do. And taxpayers are on the hook for the emergency care that many uninsured people fail to responsibly anticipate.
Republican Senator Susan Collins of Maine seems to understand this. She was willing to block the repeal of Obamacare -- but now she says she's willing to see the individual mandate go, if Congress promises two years' worth of other funding to keep premiums down. That might help in 2019, but it would not make up for the loss of the individual mandate in the long run.
Fact is, no workable replacement for the mandate has been proposed.
There's still time for Collins and other reasonable Republicans to grasp this truth, preserve the individual mandate, and keep the U.S. health-care system moving toward its rightful goal of truly universal coverage.
--Editors: Mary Duenwald, Clive Crook.
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