It’s way more than taxes: The tax bill drives a knife into Obamacare

WASHINGTON, DC - DECEMBER 20: U.S. President Donald Trump (C), House Speaker Paul Ryan (R-WI) (L), Senate Majority Leader Mitch McConnell (R-KY) (2nd L) and Vice President Mike Pence make their way to a news conference announcing Congress passing the Tax Cuts and Jobs Act with Republican members of the House and Senate on the South Lawn of the White House on December 20, 2017 in Washington, DC. The tax bill is the first major legislative victory for the GOP-controlled Congress and Trump since he took office almost one year ago. (Photo by Chip Somodevilla/Getty Images)

President Donald Trump is celebrating the Republican tax bill — the first significant piece of legislation passed all year by the party — as a repeal of the Affordable Care Act, too.

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The tax reform bill doesn’t outright repeal the law. Federal and state health insurance exchanges remain, along with the Medicaid expansion in states across the country. But the tax bill does eliminate the law’s contentious individual mandate, which imposes a tax on people who do not carry coverage.

A tax the individual mandate helps subsidize healthcare plans offered on the exchanges, most of which cover people who otherwise could not afford health insurance.

While Republicans have campaigned against the law for nearly ten years, they failed to repeal the law or even agree on a replacement for the law this year, despite majorities in the House and Senate and control of the White House.

Unable to outright repeal the Affordable Care Act, Republicans have settled on dismantling the law bit-by-bit, cutting federal subsidies, shrinking the enrollment period, and slashing its ad budget, per Politico.

By slowing enrollment and eliminating the individual mandate, the Republican tax bill hits the health exchanges where they hurt: their customers.

As healthier and wealthier people leave the exchanges, premiums will rise and some exchanges will become unstable, if not wholly unsustainable. That would lead to more counties with few options (or none whatsoever). Already, over 1,200 counties in the United States are projected to have one or no health insurance providers in 2018.

President Donald Trump and other Republicans have repeatedly used the number of counties with few or no insurance providers as an argument for repealing the Affordable Care Act, with Trump calling it “a broken promise.” The Congressional Budget Office projects that higher premiums will kick 13 million people off health insurance plans as a result of the repeal of the individual mandate.

Today, President Donald Trump tweeted thanks to Senate Majority Leader Mitch McConnell on a “fantastic job,” adding that “our team will go onto many more VICTORIES.”

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