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Why is it as deadly?
With other plans looking destined to fail, Republicans are considering a "skinny repeal" of Obamacare in hopes of just keeping the repeal process alive. If they can pass that, lawmakers can hammer out a final proposal with the House in conference committee.
Though the Senate has yet to release details, the "skinny repeal" plan would likely eliminate the individual mandate, which requires nearly all Americans to obtain health insurance or pay a penalty, and the employer mandate, which obligates larger companies to provide affordable coverage to their full-time workers. The plan would also get rid of the Obamacare tax on medical device makers.
It's unlikely that this will be the final bill that Congress sends to President Trump for his signature. But Republicans are eager to eliminate the individual mandate, which is one of the least popular provisions in the Affordable Care Act. Their repeal-only amendment, which failed to pass on Wednesday afternoon, also called for spiking the mandate but would have given lawmakers two years to figure out a replacement plan.
A provision like the individual mandate is critical because it brings young and healthy people into the market. Their premiums help offset the higher costs of those who need more medical care.
Without it, premiums would likely rise -- as would the amount the federal government has to shell out in subsidies to help people buy coverage, warns the American Academy of Actuaries, which helps insurers determine what rates to charge.
"A balanced risk pool requires enrollment of healthy individuals to keep premiums affordable and stable," Shari Westerfield, vice president of the academy's health practice council, wrote to Senate Majority Leader Mitch McConnell and Minority Leader Chuck Schumer on Tuesday.
Repealing the mandate would leave 15 million fewer people with health insurance over a decade than under the current law, according to a Congressional Budget Office review last year. Premiums would increase about 20%, the agency found.
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The former GOP leader in the House talked to the Washingtonian’s Elaina Plott and conceded that his Republican Party is in a tough spot – parts of the conservative base expect the party to repeal the ACA, because that’s what they were promised – in part because of promises he and his colleagues made that they never intended to keep.
Asked if he feels partly responsible for their current predicament, Cantor is unequivocal. “Oh,” he says, “100 percent.”
He goes further: “To give the impression that if Republicans were in control of the House and Senate, that we could do that when Obama was still in office….” His voice trails off and he shakes his head. “I never believed it.”
He says he wasn’t the only one aware of the charade: “We sort of all got what was going on, that there was this disconnect in terms of communication, because no one wanted to take the time out in the general public to even think about ‘Wait a minute – that can’t happen.’ ” But, he adds, “if you’ve got that anger working for you, you’re gonna let it be.”
In context, when Cantor says he and his party felt the need to “let it be,” he means that Republicans fed a bunch of nonsense to their own voters, then exploited their anger for electoral gain with no intention of following through.
Cantor and his colleagues, in other words, played their base for fools – because they thought it’d help them win some elections, which it did.