Inclusion of repeal in tax bill back in play as Donald Trump backs measure on Twitter

Stephanie Armour and
Kristina Peterson

Republicans may seek to repeal the Affordable Care Act requirement that most Americans must have insurance coverage or pay a fine as part of their tax overhaul package, part of a push to undo or delay parts of the health law in the aftermath of the failure of a broader repeal effort.

President Donald Trump, in posts on his Twitter account Wednesday, threw his support behind the proposal. “Wouldn’t it be great to Repeal the very unfair and unpopular Individual Mandate in ObamaCare and use those savings for further tax cuts…for the Middle Class. The House and Senate should consider ASAP as the process of final approval moves along. Push Biggest Tax Cuts EVER,” Mr. Trump wrote.

Republican leaders in both chambers have been wary of letting the political dynamics surrounding health care interfere with passing a rewrite of the tax code, but the president’s comments revived serious consideration of including a repeal of the individual mandate as part of the House GOP tax bill.

Republicans are also weighing the option of trying to include the individual mandate in a sweeping year-end legislative package, which is increasingly likely to contain a long list of unrelated items on Congress’ to-do list.

White House press secretary Sarah Huckabee Sanders said Wednesday that the White House favors repealing the individual mandate, but not at the expense of passing tax legislation.

“We’re focused on pushing through tax cuts,” she said.

Sen. Tom Cotton (R., Ark.) said Wednesday that repealing the mandate would help the math on the tax overhaul package. “My case, which is making a lot of headway, is this doesn’t make the tax bill harder to pass. It makes it easier to pass,” said Mr. Cotton.

He said he has been talking with key members of both chambers.

Part of the repeal’s allure is that it could reduce the federal deficit by about $400 billion, according to a calculation from the nonpartisan Congressional Budget Office. That is because many individuals who get insurance because of the mandate also get government subsidies, and if the mandate were repealed and those people didn’t obtain coverage, the government would no longer be paying for their subsidies. It would also reduce the number of people on Medicaid.

The latest developments unfolded on the first day of this year’s open enrollment period for the ACA, which ends on Dec. 15. The number of enrollments is likely to factor into the debate over the future of the ACA.

Consumers began signing up for 2018 health plans at a steady though not overwhelming clip, according to several enrollment assisters across the country contracted through the ACA to help people sign up for coverage.

The law’s main website,, was functioning with no major outages, advocates said. But a tool on the site designed to let shoppers compare plans frequently displayed inaccurate information on premiums—with prices sometimes fluctuating before a consumer’s eyes.

Consumer advocates also said that recent news reports on the uncertain fate of the health law had left shoppers unusually confused.

“We’re getting questions like, ‘Am I gonna be covered next year?’ or, ‘I’ve heard on the news that there’s no plans available anymore,’” said Daniel Bouton, director of community health services at the Community Counsel, a Dallas-based organization offering enrollment assistance.

In their tax overhaul, Republicans are scrambling to find ways to pay for the cost of lowering both individual- and corporate-tax rates. Their proposal can add no more than $1.5 trillion over 10 years to the federal budget deficit to comply with Senate procedural rules.

House Republicans said repealing the individual mandate would help with their search for revenues to offset the cost of the tax cuts.

“We need to have the pay-fors that we can get,” said Rep. Dennis Ross (R., Fla.) But Mr. Ross said he anticipated that repealing the individual mandate could spark pushback from some states.

House Republicans asked White House Director of Legislative Affairs Marc Short about the idea when he huddled with the Republican Study Committee on Wednesday. Rep. Mark Walker (R., N.C.) said Mr. Short responded that the idea was “not out of the question.”

While most Republicans in both chambers want to repeal the individual mandate, many are hesitant about attaching it to the tax bill.

“I’d like to see us repeal the Obamacare individual mandate. I think there’s better places to do it,” said Rep. Tom MacArthur (R., N.J.) “I don’t want to make this bill more complicated than it already is.”

The discussion Wednesday marked the latest twist in the debate over the contours of the House GOP tax bill.

House Ways and Means Committee Chairman Kevin Brady (R., Texas) on Tuesday played down the likelihood the repeal would be included in a tax overhaul. When asked by radio host Hugh Hewitt about the idea, Mr. Brady said, “Well, I don’t think it is, and here’s why. Look, I love these ideas from senators on health care, but what my constituents are looking at are for action on health care from our senators.”

Some other lawmakers also gave it tepid support.

“My concern is that while I do not support the individual mandate, I worry that it would impede progress on the tax reform process,” said Sen. Susan Collins (R., Maine).

Senate Finance Committee Chairman Orrin Hatch (R., Utah) said Wednesday he supports repealing the individual mandate, but believes efforts to dismantle the ACA should be handled separately from the tax overhaul.

Mr. Trump could also opt to end the individual mandate on his own and has been widely expected to do so in future executive orders on health policy.

Health analysts say the mandate keeps the ACA’s markets stable by ensuring that younger and healthier people obtain coverage, offsetting the costs of less-healthy individuals.

About seven million people in 2016 reported owing a penalty for not having coverage the year before, according to the Internal Revenue Service. The fee is 2.5% of household income or $695 per person, whichever is higher.

Republican leaders have been hesitant to include anything related to the ACA in the tax bill after GOP lawmakers repeatedly failed to repeal the Obama-era health law earlier this year.

Repealing the individual mandate would make attracting Democratic support much harder, particularly in the Senate where Republicans are hoping to win over some Democrats who face re-election next year in conservative-leaning states.

Sen. Jerry Moran (R., Kan.) said he supports repealing the individual mandate. “But I also know we don’t want to complicate passage of tax reform,” he said. “Combining the two creates less likelihood of a bipartisan approach to taxes.”

Sen. Jon Tester, a Democrat up for re-election next year in Republican-leaning Montana, said he was worried that if Republicans repealed the individual mandate, they would also try to tack on measures to lower premiums by gutting consumer protections.

“I hate the mandate,” Mr. Tester said Wednesday. “But if you’re going to repeal it, that means you’re repealing all this other stuff that I like. So let’s find out what they really want to do.”

Still, momentum has built for knocking down or delaying parts of the ACA, including a two-year postponement on a health-insurance tax and a medical-devices tax.