The Senate’s Tax Reform Bill Puts Public Health at Risk

In a sneak attack akin to Pearl Harbor, the Senate sought to deal a death blow to health insurance coverage under the Affordable Care Act by its last minute addition of the repeal of the individual responsibility mandate into its tax reform bill.  The Congressional Budget Office estimated that this would lead health insurance coverage to fall by 13 million and to raise health insurance premiums by 10 percent.  Combined with President Trump's efforts to undermine the health insurance exchanges by ending cost-sharing reductions that help low-income Americans afford insurance, slashing funding for outreach and cutting back enrollment periods, we see a continuing pattern to create havoc in the health insurance markets.  No public hearings were ever held to discuss these subjects with the public or even with other Senators; these were plotted and executed in back room deals.This provision is not contained in the tax bill passed by the House of Representatives, but it seems likely that the House would agree to this change when Republican Senators and Congressmen meet to iron out differences between their versions.  Is this the Christmas present the nation deserves?  Bah, Humbug.Leighton Ku, PhD, MPH, is a Professor and Director of the Center for Health Policy Research at the George Washington University’s Milken Institute School of Public Health.  He is also an Executive Board member for the District of Columbia’s Health Benefit Exchange Authority.