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Republicans Add ACA Mandate Repeal To Tax Bill


The individual mandate could go away if some Republican senators have their way. The mandate is a requirement to buy health insurance, part of the Affordable Care Act. President Trump wants to get rid of the mandate as part of a tax overhaul bill, and Senate Republicans appear to be taking him up on that. NPR national political correspondent Mara Liasson is with us. So what does it mean, really, to lose the mandate?

MARA LIASSON, BYLINE: What it means is that if you don't want to buy insurance, you don't have to and you won't be fined if you don't. That's what the mandate is. It's a fine or a tax for not being insured. So presumably, more healthy people would choose not to buy insurance. And the Congressional Budget Office estimates that if that happens, the Treasury would save about $380 billion over 10 years. But also, 13 million fewer people would be insured over a decade, but it would help Republicans pay for tax cuts.

INSKEEP: OK. So it's tugging on one of the threads that is the sweater that is Obamacare, basically, is what you're saying?

LIASSON: That's right.

INSKEEP: OK. So it would damage Obamacare further. It would have certain budget effects. What are the political effects, though? Does it make this tax bill more likely to pass if the removal of the mandate is part of it?

LIASSON: That's certainly what Republicans think, that if you get rid of the mandate, add it to the tax bill, you're going to appeal to certain conservatives who maybe didn't like other parts of the tax bill but really want to get rid of Obamacare. This would be a way for Republicans to finally say after all those failed attempts to repeal Obamacare, that they've stuck a dagger in the heart of the Affordable Care Act. It is the most - the mandate is the most unpopular part of Obamacare, and Republicans think it's a way to get more votes. Now, you could scare off some moderates like Susan Collins by putting health care in the tax bill. But overall, Republicans feel it will help them get votes.

INSKEEP: That's the part I don't understand, though, Mara, because they're turning this tax bill into a health care bill. And they have several times tried to pass a health care bill, and they have repeatedly failed. When you talk to Republican leaders, why do they think it's going to work this time?

LIASSON: Because this is only about the most unpopular part of the health care bill. You're not getting rid of the really - the things that people like - the subsidies or the ability to stay on your parents' plan till you're 26. This is a way that Republicans can go back to their base and back to their donors and say, we actually did something. After voting and failing to repeal Obamacare for seven years, we finally took a really - a mortal blow at it. Even though this will probably cause premiums, according to the CBO, premiums to go up by an average of 10 percent and that could open up Republicans to being blamed for that, they still feel on the whole this is a good thing for them politically.

INSKEEP: How desperate are Republicans to pass some piece of major legislation before 2017 is done?

LIASSON: Oh, they absolutely have to pass this tax bill. This has become an almost existential bill for them. That's why it's barreling along so fast. They have to pass it. They have to be able to go home to voters and say, we can govern.

INSKEEP: And to their donors as well. Lindsey Graham, the senator from South Carolina, said the other day, we're going to lose donations if we don't pass this tax bill.

LIASSON: Absolutely. Donors have put them on notice - show you can govern or we're closing our wallets.

INSKEEP: Mara, always a pleasure. Thanks for talking with you.

LIASSON: Thank you.

INSKEEP: NPR national political correspondent Mara Liasson. Transcript provided by NPR, Copyright NPR.

Mara Liasson is a national political correspondent for NPR. Her reports can be heard regularly on NPR's award-winning newsmagazine programs Morning Edition and All Things Considered. Liasson provides extensive coverage of politics and policy from Washington, DC — focusing on the White House and Congress — and also reports on political trends beyond the Beltway.