Six healthcare organizations are urging Senate and House leaders to keep the individual insurance mandate that would be axed under the Senate's tax reform bill.
Without the mandate, there would be significant premium increases which would decrease the number of people who have insurance, said America's Health Insurance Plans, the American Academy of Family Physicians, the American Hospital Association, the American Medical Association, Blue Cross, Blue Shield Association and the Federation of American Hospitals.
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Providers and payers rely on the mandate to keep down the cost of uncompensated care and for a stable health insurance market.
"Broad and sustained enrollment contributes to affordable coverage as costs are shared across a larger pool of individuals," the November 14 letter states. "Repealing the individual mandate without a workable alternative will reduce enrollment, further destabilizing an already fragile individual and small group health insurance market on which more than 10 million Americans rely."
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The letter was sent to Senate Majority Leader Mitch McConnell, Senate Democratic Leader Charles Schumer, Speaker of the House Paul Ryan and House Democratic Leader Nancy Pelosi.
An earlier House tax reform bill does not include repeal of the individual mandate of the Affordable Care Act. It was also missing from an earlier version of the Senate bill, but the Senate Finance Committee is currently working on a tax bill that does include elimination of the mandate.
House Republicans plan to vote on their bill Thursday, according to CNBC. Once the Senate passes its own bill, both versions would be reconciled.
Senate Finance Committee Chairman Orrin Hatch said the individual mandate is failing Americans. Premiums in the ACA are so high that Americans are paying the fine for not having health insurance rather than paying for coverage.
Over 80 percent of households that pay the penalty for not having health insurance make less than $50,000 a year, Hatch said. This year, the penalty for not purchasing insurance is 2.5 percent of income, he said.
Senate Finance Committee Ranking Member Ron Wyden, a Democrat, said Republicans are choosing corporate tax cuts over healthcare for millions.
Last week, he said, the Congressional Budget Office released an analysis that showed repeal of the individual health insurance mandate would result in 13 million fewer Americans covered by 2027.
Repealing the mandate would also result in premiums going up by 10 percent, he said.
Andy Slavitt, former acting administrator for the Centers for Medicare and Medicaid Services is an active proponent of the ACA.
On Twitter Slavitt said the impact of the tax law of both the Senate and House bills would be a 4 percent cut to Medicare; an 11-16 percent increase in the number of uninsured, an estimated 13 million people, and a 10 percent increase in premiums.
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com