Repealing the Individual Mandate is the Worst Tax Reform Idea Out There


As the push for tax reform on Capitol Hill moves forward, President Trump continues his misguided calls to repeal the Affordable Care Act’s (ACA) individual mandate as part of the final package. Unfortunately, he isn’t alone.

Despite Congress’s repeated failure to replace the ACA, some Republicans in both the House and Senate still seem convinced that the missing tax reform ingredient is a provision that the Congressional Budget Office (CBO) has estimated would result in 13 million Americans losing coverage, and an overall increase in premiums for health care consumers nationwide.

Experts who have analyzed the ACA have repeatedly found that without the mandate, the health care system the bill implemented simply would not work. With the mandate in place, those who might otherwise be less likely to obtain coverage – such as young adults and those who currently enjoy good health – are incentivized to get covered. This in turn leads to lower premiums across the board by offsetting costs for sicker patients.

Despite the harm this policy proposal would inflict on health care consumers, any serious consideration of the individual mandate repeal is more likely fueled by the fact that the Republican base is dissatisfied with the President and Congress’s inability to advance their overall legislative agenda, perhaps most notably when it comes to health care.

The proposal to repeal the individual mandate is all the more puzzling given recent news that the two week-old Open Enrollment period has seen a surge in consumers signing up for or renewing their health coverage via the federal marketplace, despite the Trump administration’s refusal to adequately promote it. Moreover, voters in Maine voted last Tuesday to expand Medicaid and help an estimated 70,000 low-income residents obtain coverage. These are just the latest indications that voters overwhelmingly support policies that increase access to care, rather than reduce it.

When it comes to the individual mandate and health care reform in general, we continue to urge Congress to listen to nurses when considering the best way to move forward on transforming America’s health care system. Join us and add your voice by clicking here.

Will you #EndNurseAbuse?


This guest post is by Alex Wubbels, RN. 


Back in late July, I was arrested for following my hospital’s policy and protecting an unconscious patient who could not consent to a blood draw. I was wrongfully seized by force in the middle of the emergency department.

Even though my story made national news, most do not. Did you hear about the emergency department nurse who was stabbed by a patient in Massachusetts? Or the Arkansas nurse who was pushed down a flight of stairs? Or the two nurses in Illinois who were taken hostage (one of whom was beaten and raped)? Sadly, the list goes on and on. With one out of every four nurses reporting that they’ve been assaulted at work, you’ve either experienced this personally or know a colleague who has been abused.

The fact that we are more likely to experience violence on the job than prison guards or police officers is unacceptable, and we must work together to #EndNurseAbuse.

As an ANA member, I was fortunate to have the support of my organization, community, and a tribe of fellow nurses during this difficult time.

I truly believe that what happened to me can lead to positive change in our profession. That’s why I decided to speak out: to stop this abuse from happening to others. I’ve teamed up with ANA to ask you to sign our pledge and stop this culture of violence. I am committed to this goal so we are not put in situations where we have to fear for our safety, or have to choose between our jobs and our licenses.

By adding your name, you’re saying you support zero tolerance when it comes to violence against nurses; that you’ll report abuse whenever you safely can; and that you’ll share with others asking them to sign too.

Please join me by adding your name and taking the pledge.

Thank you,
Alex Wubbels, RN

A committee hearing reveals why Graham-Cassidy is struggling to pick up supporters

Photo: J. Scott Applewhite, AP
Photo: J. Scott Applewhite, AP

With a vote looming as soon as Wednesday, members of the Senate Finance Committee assembled earlier today to hold a hearing on the Graham-Cassidy healthcare reform proposal and were met, immediately and unsurprisingly, with protest, as disability rights advocates continued their strong opposition to Republican efforts to cutting Medicaid, a key plank of Graham-Cassidy.

In spite of last minute changes to the bill to try to persuade Senators who haven’t publicly opposed it, the committee hearing put a spotlight on the bill’s long list of shortcomings, and perhaps unintentionally provided a showcase for why the legislation is struggling to win a majority of votes, from its emphasis on block grants for Medicaid to re-introducing coverage penalties for those with pre-existing condition.

Despite this, Sen. Bill Cassidy (R-LA), one of the bill’s chief sponsors, offered a number of arguments intended to win back support that critics called misleading. Cassidy noted, for example, that states could expand Medicaid if they desired to do so – despite the fact that his bill repeals expansion eligibility, and it’s unclear what steps states would have to take to restart expansion.

Late last week, Sen. John McCain (R-AZ) removed himself from that list of undecided Senators by publicly stating that he couldn’t vote for a bill like Graham-Cassidy that hadn’t gone through regular order and had only garnered support from members of one political party.

Finally, as the day came to a close, the Congressional Budget Office once again weighed in and found that this version of repeal-and-replace, much like previous versions, would strip care away from millions of Americans, though it could not be more specific due to the wide latitude the legislation would give to states, particularly regarding cuts to Medicaid. As she did in late July, Sen. Susan Collins also announced her opposition, potentially dooming Graham-Cassidy once and for all.

ANA formally announced its opposition, and continues to urge all nurses and advocates who care about strengthening affordable care to reach out to their Senators by clicking here.