Sneaky Repeal Effort Underway

The Republicans are looking for a big win, and hoping they find it with tax “reform” – but it just looks like way to take money from the most vulnerable to give a big tax break to the wealthiest. House Republicans passed their tax bill before Thanksgiving recess and the Senate Republicans plan to bring their version to the floor as early as Thursday. The Senate proposal would remove the Affordable Care Act (ACA) requirement that everyone buy health insurance and increase the deficit by $1.4 trillion. This bill would hurt low-income Americans, primarily because of a loss of government financing of health care.

A new Congressional Budget Office (CBO) report finds:

  • By 2019, Americans earning less than $30,000 a year would be worse off under the Senate bill.
  • By 2021, Americans earning $40,000 or less would be net losers.
  • By 2027, most people earning less than $75,000 a year would be worse off.
  • Millionaires and those earning $100,000 to $500,000 would win out.

Republicans argue the CBO analysis (and a similar finding from the Joint Committee on Taxation) results from an “accounting gimmick” because the bill doesn’t explicitly take away anyone’s health care – it just gives them the choice to have it or go without.

Unfortunately, Senator Susan Collins (ME), who has voted against the “repeal and replace” efforts, is signaling support for the tax bill if her party agrees to pass the Alexander-Murray bill and her bill on reinsurance. We support these bills, but they will not make up for the loss of the individual mandate. On a procedural note, we expect the Senate to first vote on the House bill, and then substitute their own proposal as an amendment. A final vote is expected by Saturday.


While the House bill doesn’t repeal the individual mandate in their bill, they do repeal the medical expense deduction. This provision could be devastating for people with disabilities and chronic conditions, and seniors. A recent Kaiser poll found that 68% of the public opposes eliminating this deduction. Many people oppose it because they think it will affect them and their families. Beyond the need for a medical expense deduction, accessing care remains unaffordable for many because of the cost of deductibles and co-pays. The Kaiser Family Foundation found that many families (four in ten) just don’t have the resources to cover a deductible of $3,000.

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