By Mike DeBonis
WASHINGTON - President Donald Trump is pushing Republican leaders in Congress to make a major and potentially explosive change to their tax bill, directing them to use the legislation to begin dismantling the Affordable Care Act.
After months of failed attempts to repeal President Barack Obama’s signature health care law, Trump wants lawmakers to include a provision to the tax cut legislation that would repeal the “individual mandate,” a part of the health law that requires most Americans to pursue health insurance.
Trump raised the idea of attaching the health care change to the tax bill several days ago in a Twitter post, but it was quickly dismissed by other White House officials and congressional leaders who were eager to see the tax bill move through Congress without any distractions.
Republican leaders still say they’re unlikely to add the health care change, but Trump has not relented, and on Friday the head of the House GOP tax effort said the party was were taking a preliminary step to explore the possibility.
House Ways and Means Committee Chairman Kevin Brady, R-Texas, said Trump has personally requested he include repeal of the mandate - the health law’s chief mechanism to compel Americans to become insured and to keep the insurance market stable.
“The president feels very strongly about including this at some step before the final process,” Brady said at a Friday event hosted by Politico. “He’s told me that twice by phone and once in person . . . And members have as well.”
If Republicans were to pass legislation that both made sweeping tax changes and undermined the ACA, it would accomplish two of Trump’s top legislative priorities - and in one stroke reverse Republicans’ legislative fortunes after a string of legislative setbacks.
But adding the controversial health care change would further complicate the tax effort. Republicans hold majorities in the House and Senate, but internal party divides make finding enough votes for tax reform a challenge, and the party already tried multiple times to repeal the ACA but was unable to find the votes.
Brady hinted Friday he was not inclined to introduce a new complication into the 400-plus-page bill, which was introduced Thursday after months of negotiations. The repeal of the mandate was not included in the initial draft of the Tax Cuts and Jobs Act released Thursday, nor in the update to the bill Brady proposed Friday.
“Importing health care into the tax reform debate has consequences, especially when the Senate has yet to produce 50 votes on anything related to health care that I’m aware of,” he said. “Clearly you’re bringing a whole new element into pro-growth tax reform.”
Brady did say said his committee has requested an updated analysis of repealing the mandate from Congress’s nonpartisan scorekeepers. A previous analysis from the Congressional Budget Office issued last year found that eliminating the mandate would decrease deficits by $416 billion over a decade. Trump, in his Twitter post earlier in the week, has said that including this change would allow them to cut more taxes for the middle class. The tax cut package has so far tilted more toward cutting back on taxes for businesses.
But CBO also found that repealing the individual mandate would lead to 15 million fewer Americans purchasing insurance and an increase in premiums for those who are insured on the individual market.
The ACA prevents health insurance companies from denying coverage to people with preexisting conditions. But without the mandate that all people get coverage, health care experts say private individual insurance markets would collapse, as many people would wait to buy insurance until they got sick, leaving private insurance companies with mostly expensive customers and causing premiums to skyrocket.
Two senior GOP aides said Friday that top House leaders are inclined against adding the health-care provision because they believe it could delay the bill’s passage and that the measure would ultimately be rejected in the Senate.
“If it’s a poison pill, it won’t happen, so I’m not worried about it,” said Grover Norquist, . Norquist added that if three Senate Republicans voice an objection to the change, it will prevent Senate GOP leaders from from trying to attach it to the bill.
Numerous White House officials believe attaching changes to the Affordable Care Act to the tax package would be a terrible idea, potentially dooming the entire tax bill. But Trump remains enamored with the idea, driven by conversations with Sen. Tom Cotton, R-Ark., and Sen. Rand Paul, R-Ky., who are aggressively promoting it.
House conservatives are pushing - gently, for the moment - to include the mandate’s repeal in the tax legislation.
“It’s good policy. It’s the right thing to do,” Rep. Jim Jordan, R-Ohio, a leader of the GOP’s hard-right bloc, said Friday. “I don’t know why we wouldn’t.”
Brady introduced his version of the tax cut bill on Thursday, and he hopes to begin holding votes on it in his committee on Monday. He then wants to bring the legislation to the House floor for a vote before Thanksgiving, and Senate Republicans are hoping to move quickly as well.
Senate Minority Leader Charles Schumer, D-N.Y., told reporters Friday that he considered it “unlikely” that the mandate’s repeal would ultimately be added. “A lot of the Republicans said this bill is too heavy a lift already,” he said. “To add that to it might be the straw that would break the camel’s back.”