Does the GOP Tax Law effectively repeal ObamaCare?
It repeals the “individual mandate,” which in theory is essential for ObamaCare to work at all. In practice, it is yet to be seen what will happen.
<personal opinion removed upon remembering which forum we are in>
It repeals the requirement that you must have health insurance or pay a penalty after 2018. It does not change the underlying structure of tax credits nor anything about the coverage requirements such as coverage for pre-existing conditions, elimination of lifetime maximums, ability to stay on parental policies until 26, etc.
It also did not end adult group Medicaid (the Medicaid expansion) or payment and delivery system reforms launched by the ACA.
Ending the mandate is likely to cause some insurance companies to raise premiums or pull out of the market. Economists debate how well the mandate has worked (it’s quite cheap compared to insurance), but insurers think it works, and that’s usually what matters.
I just found an article that says everything I just typed but better. I should have found the article first!
One catch is that the tax plan does not repeal the part that says that insurance companies can’t turn people away for pre-existing conditions. So someone could still go without insurance while they’re young and healthy, but then buy it as soon as they get sick. Which would not be very healthy for the insurance companies’ bottom lines.
They could only buy it during the open enrollment period, which limits (but does not eliminate) that type of gamesmanship.
Also worth noting, in the first few years of Obamacare, the penalty for not enrolling was very low.
This is exactly why next year, the State options for coverage that insurance companies provide will essentially disappear… Effectively killing “Obamacare” and all it’s remnant benefits… The benefit only exists if there is a policy to back it up. Take away the policy, the benefit doesn’t exist.
I don’t understand this. Can you explain?
Ending the mandate will cause premiums to go up, but the government is still required to subsidize premiums, given the tax cuts will have to print money to do so. I’m disabled but have always preferred to work simple low paying jobs and not go on disability. The ACA has been a gift that keeps on giving for me, I got a Gold level policy this year from BCBS Texas that only costs me 65.00 a month. But 2018 looks like the year Republicans will have to take the poison pill of actually dismembering the program, it’s really gonna bust the budget now.
Been happening since the second year where I live.
They will either raise their premiums to an outrageous and unaffordable level in order to cover this situation (as before Obamacare, and the “individual mandate”) or, simply drop out of the market. Either way, it effectively defunds the process.
What will happen in Mass, which had Romneycare before Obamacare?
IMHO, this thread really belongs in IMHO. I think the only answer is no one really knows and we will have to wait and see.
This notion is purely a matter of perspective, and ** how much “required” subsidization** is purely speculative… Depending upon how much money they are willing to print in the short run is the key in this scenario.
Sorry, I was not clear with my question.
What are the “State options for coverage” provided by insurance companies? (I understand that premiums will probably rise and companies will drop out - but fail to see that as a state option.)
At this time, you’re absolutely correct, no one here has the answer since this legislation was passed under the cover of darkness. However, ultimately the answer will be a matter of fact, and so may be appropriate here in GQ.
As I understand , the options (State coverage) are in the insurers’ hands, not in the States themselves. Therefore it is the insurer, not the State that decides what coverage is offered.
That state-level mandate is still in effect and we might see other states enact their own state-level mandates.
Question: Was it because the mandate was a “tax” that a 50-vote repeal was possible (under “reconciliation”), while repealing other parts of ACA would have been subject to filibuster?
Yes, because it is a tax or otherwise produced a change in “outlays or revenues” that wasn’t merely incidental. They also could have, for example, changed the tax credits for the ACA. But they couldn’t change the rule that said people aged 26 and below could stay on their parents’ insurance even though that would change the amount of outlays the federal government has because it drives up insurance costs.
The reconciliation rule doesn’t actually allow them to repeal a tax, because reconciliation is only allowed to be used on measures which decrease the deficit (i.e., tax increases or spending decreases), not on ones which increase it. But they did it anyway, and the Senate is the arbiter of its own rules, and so there isn’t any recourse for when they violate them.
Ok. This will vary by state - in WA State, we have an insurance board and commissioner who approves or disapproves changes, including premiums, requested by insurers.
Exact coverage standards are written into Obamacare and cannot be changed much.
The irony of this whole mess is that the repeal of the mandate has no effect on the 20-30 million MedicAid expansion users - they get the dreaded and scary “government funded healthcare”.
For the 10 million or so responsible, free-market healthcare customers - only those poor enough to qualify for government subsidies will be able to afford coverage. As premiums rise, individual payers will drop out of the program.
The net result of killing the mandate will very likely mean more people dependent on the government for healthcare.
In other words, our Republican legislators just moved us closer to socialized healthcare…