Republicans take another swing at Obamacare

Republicans in Congress spent much of 2017 seeking to repeal and replace the Affordable Care Act. After repeated attempts failed, they celebrated a victory with the passage of the Tax Cuts and Jobs Act of 2017. While the tax bill left most of the ACA intact, it included the repeal of the ACA’s individual shared responsibility penalty, the penalty imposed on individuals who fail to purchase qualified insurance coverage.

That means the so-called individual mandate remains in the ACA but, beginning in 2019, individuals will no longer face a financial penalty if they choose not to purchase health insurance.

Health policy experts agree that this will destabilize the individual insurance market. With the ACA allowing people with pre-existing conditions to purchase health insurance at the same price as others, the individual mandate was a necessary counterbalance that encouraged healthy people to purchase insurance and stabilize premiums.

Emboldened by the legislative success of GOP tax reform, 20 states led by Texas and Wisconsin have renewed efforts to weaken and undo the ACA.

We study health policy and health care law and have watched the attacks on the law. We believe this latest legal challenge will likely fail but can still damage the ACA and insurance markets by exacerbating the uncertainty sown by actions of the Trump administration as the states-led suit meanders through the courts over the next years.