Author: Brian Davis

Massive tax bill will significantly reduce the number of Americans with health insurance

Silver Spring, MD – The following statement is attributable to Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA), in response to the Tax Cuts and Jobs Act.

“The American Nurses Association is deeply concerned about the devastating impact that the Tax Cuts and Jobs Act will have on health care in this country. Under the guise of a promise to slash taxes for corporations and middle-class Americans is a clear intent to dismantle the Affordable Care Act (ACA), which has helped nearly 16 million Americans obtain health coverage. It is also no secret the actions that will be pursued to make up for the inflated deficit caused by this tax bill will be the cutting of essential anti-poverty programs as well as Medicare and Medicaid.

Eliminating the ACA’s individual mandate will lead to an estimated 13 million fewer Americans having health insurance. The resulting domino effect will be negative health outcomes, higher costs, and fewer individuals with access to critical primary care and preventive services. This is irresponsible and further proves that health care is being handled like a political game to be won at any cost. Frustratingly, this bill was pushed through without input from patients, consumers, or health care experts, including the country’s 3.6 million registered nurses, whom the public ranks as the most ‘honest and ethical’ profession.

Amid numerous failed attempts to ‘repeal and replace’ the ACA, ANA voiced strong opposition to legislation that would threaten health care affordability, access, and delivery for millions of people across the nation. ANA will continue to advocate for a health system that ensures universal access to a standard package of essential health care services for all citizens and residents.”

For high resolution images of the ANA logo or photos of ANA leadership, please click here.

With the Senate speeding toward a final vote on tax reform legislation, Majority Leader Mitch McConnell (R-KY) and his leadership team are considering the inclusion of two additional health care proposals. Their hope is that these proposals will persuade undecided Senators to vote yes and make up for the fact that the bill includes the misguided decision to repeal the individual mandate. Unfortunately, while these proposals may have merit on their own, they won’t be enough to mitigate the damage caused by individual mandate repeal, which the Congressional Budget Office (CBO) estimates will lead to 13 million Americans losing health coverage.

Proponents of the two proposals have claimed that they would at least mitigate – if not completely undo – the harm of individual mandate repeal. The first, from Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) would restore cost sharing reduction (CSR) payments through 2019, after the Trump administration unilaterally decided to end the payments earlier this year.

The second, from Sens. Susan Collins (R-ME) and Bill Nelson (D-FL), provides $2.5 billion in both 2018 and 2019 for state reinsurance programs, which reimburse insurers for some or all of the costs associated with highest-cost claims.

However, without the individual mandate, fewer healthy people will sign up for coverage and average costs and premiums across the individual market will rise by 10 percent, according to the CBO; some providers have projected even larger increases. To offset this 10 percent increase, $10 billion in federal reinsurance funds would be needed each year (as opposed to the temporary “solution” offered by Collins-Nelson).

Worse, repealing the individual mandate increases uncertainty and instability about future open enrollment periods, risk pool profiles, and premium rates. Put simply, insurers would be forced to reconsider whether they want to continue taking part in the health insurance marketplace at all, a recipe for further disruption and additional loss of coverage among individual market enrollees.

Finally, while the Alexander-Murray proposal to reinstate CSR payments would be a laudable approach on its own, CBO has found that it would also fail to reverse the coverage reductions that will result from individual mandate repeal. In short, repeal creates a problem far bigger than the one Alexander-Murray was initially intended to address.

With a final vote looming, now is the time to tell your Senators that they should stand with patients and reject this bill. In the absence of substantive debate and expert input, grassroots pressure is the best hope for stopping this harmful legislation once and for all.

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.