After being unable several times this year to agree on a way to repeal and replace the Affordable Care Act, the Senate is going to try to tackle one of the law's most controversial pieces in a tax bill it hopes to pass before Christmas.
Senate Majority Leader Mitch McConnell said Tuesday that the Republican tax plan unveiled last week will be revised to include a provision repealing the mandate that everyone have health insurance, a centerpiece of the Obamacare law.
“We’re optimistic that inserting the individual mandate repeal would be helpful” in getting 51 yes votes on the tax bill, the Kentucky Republican said.
President Trump suggested on Twitter on Monday that the House and Senate include the repeal in bills that were already moving without it.
Trump focused on using the budget savings from the repeal to bring down the top tax bracket, but Congress may have other uses for the money because the budget resolution they passed last month said they could not increase the national debt by more than $1.5 trillion over the coming decade.
Bills pending in the House and Senate have different proposed top rates — 39.6% for the House bill, 38.5% for the Senate. Both would only make couples earning more than $1 million and individuals making more than $500,000 subject to the top rate.
A top White House official said Tuesday that while Trump wants the repeal, it would not be a deal-breaker for the tax bill.
"We want the very best tax bill that can pass," Office of Management and Budget Director Mick Mulvaney told reporters. "If adding a repeal of the individual mandate makes it easier to pass, great. If keeping it off makes it easier to pass, we’ll take that as well."
The mandate is enforced by the Internal Revenue Service, which is supposed to assess penalties on people who do not have coverage. The mandate was intended to encourage younger, healthier people to buy coverage and therefore spread the cost of insuring sicker people among a wider part of the population.
The Congressional Budget Office has estimated that repealing the health insurance mandate would save the government about $338 billion over the coming decade because people would choose not to sign up for Medicaid or for insurance sold through government exchanges that have subsidized premiums. CBO's report also said a repeal would lead to 4 million fewer people with insurance next year, 13 million fewer in 2027, and rate increases of about 10% for those who remain in the exchanges.
Word about the Senate consideration of the change led a conservative group in the House to call for it to be added to the House version of the tax bill before a vote Thursday.
“Let’s repeal the individual mandate and restart the process of repealing Obamacare.” the Republican Study Committee said in a statement.
House Ways and Means Chairman Kevin Brady, R-Texas, said Monday the repeal "remains under consideration."
But it was not actually part of the bill that the Senate Finance Committee began debating on Monday, and at the start of a meeting after McConnell spoke, Chairman Orrin Hatch, R-Utah, said, "No one needs to be talking about the individual mandate at this point.”
That did not sit well with Democrats, who pointed to McConnell's comment and argued they needed to be able to debate other parts of health care if that was becoming a focus of the tax bill.
"We were never told health care was going to be part of it and this just flew in in the last 20 minutes out of nowhere," said Sen. Ron Wyden of Oregon, the top-ranking Democrat on the committee.
Sen. Rand Paul, R-Ky., said Tuesday he would seek to amend the Senate bill to include a repeal of the mandate. Rather than apply the savings toward the top rate, as Trump suggested, Paul said he would apply it to "fix a problem in the Senate bill where many taxpayers would see a tax increase because of the loss of state and local deductions."
Contributing: Deirdre Shesgreen