The main criticism health care advocates and organizations across the state — including the American Cancer Society, American Heart Association and National Organization for Rare Disorders — lodged against the Tax Cuts and Jobs Act was its similarity to the failed Graham-Cassidy Bill, which sought to roll back many of the provisions of the Affordable Care Act, including the individual mandate.
The Senate is expected to vote on the tax reform bill next week. After Sen. Lamar Alexander announced his support for the bill, activists against the proposed legislation said Tennessee Sen. Bob Corker’s vote could be pivotal.
“The individual mandate is a particularly cruel tax to lower-income Tennesseans — most of the people who pay the individual mandate tax make less than $50,000 a year — so it’s a good tax to repeal when you’re writing a tax cut bill,” Alexander wrote in a statement to the Johnson City Press.
In an email to the Press Monday, Corker’s spokesman Micah Johnson said the senator is “still closely reviewing the legislation.”
On Nov. 2, Corker voiced his support for tax reforms, but he did not address the current tax bill’s health care stipulations.
“Throughout my time in public service, I have been a strong advocate for pro-growth tax reform and, like my colleagues, am excited about the possibility of producing the biggest tax rewrite since 1986,” Corker said. “That said, I cannot stress enough that what I care about is doing this right and implementing sound policy. As I have made clear from the beginning of this debate, it is my hope that the final legislation — while allowing for current policy assumptions and reasonable dynamic scoring — will not add to the deficit, sets rates that are permanent in nature, and closes a minimum of $4 trillion in loopholes and special interest deductions.
“I appreciate the work the Senate tax-writing committee is doing to finalize legislative text and look forward to the debate ahead.”
The Congressional Budget Office estimated the tax bill could add $1.7 trillion to the national deficit. To avoid a Senate rule that would prevent the legislation from going to reconciliation if it increases the budget by more than $1.5 trillion, the Senate’s version makes many of the cuts for individuals temporary, but leaves in place a cut to the corporate tax rate and other cuts for businesses.
Dr. Andrew Pfeffer, a physician at Vanderbilt University, said the bill proposes cuts to Medicaid and Medicare to help make up for this deficit.
Coupled with the repeal of the individual mandate, Pfeffer said the bill’s health care cuts will increase costs for care and cause people to drop their insurance plans. This, he said, will effectively destabilize the market. He said the tax bill is so bad that it has unified groups in opposition — like doctors and insurance companies — that often disagree on major health issues.
“Basically, if you repeal the mandate, healthy people will leave the market, and that will increase premiums and push more people out of the market,” he said.
Pfeffer said the tax reform bill could lead to 13 million people losing insurance, and said there’s no real difference between what Congress is now about to enact in the tax bill and the “failed health bills” that many in the public “soundly rejected” months ago.
He called these attempts an “attack on health care that will lead to horrible results for Americans.”
“It’s going to increase inequality and lead to bad health care quality for everyone. Nobody wins when you attack health care,” he said. “Everybody needs care. I don’t care how healthy you are.”
Sarah Simpson from Family Voices of Tennessee urged Tennesseans to contact their representatives and voice their opposition to the legislation.
“This bill is deeply concerning to our families,” she said.
After a $25 billion cut to Medicare and an increase in premiums, Lynn Williams from the American Cancer Society said patients with pre-existing and or chronic conditions will find affordable coverage difficult to find.
“By definition, that means cancer patients and cancer survivors,” Williams said.
On Sunday morning news programs, Trump budget director Mick Mulvaney said the administration wants the individual mandate for health insurance to be repealed, but said the White House would be open to removing that provision after some Republican senators said they were uncomfortable with it.