In the next few weeks, the U.S. Senate will consider a Republican tax plan and it's very likely that the future of the Obamacare individual health insurance mandate will be a big part of that debate.
Senate Republican leaders were unable to eliminate the mandate when their plan to repeal and replace the Affordable Care Act failed several months ago. They are now eyeing the tax legislation as a way to achieve their goal.
Green Mountain Care Board chairman Kevin Mullin says it's a big mistake for the Republicans to do away with the individual mandate.
"So I think that the mandate makes sense at least in my point of view if you're going to try to have a system that takes care of everyone, everyone has to contribute," said Mullin.
Mullin -- who is a Republican -- says dropping the mandate will boost premiums for several reasons. He says the insurance companies will lose young, healthy customers and the amount of uncompensated care will rise because some uninsured people will still need to use the health care system.
And Mullin is concerned that the number of people without insurance in Vermont will begin to rise if the individual mandate is eliminated.
"So I think that the mandate makes sense at least in my point of view if you're going to try to have a system that takes care of everyone, everyone has to contribute."—Green Mountain Care Board chairman Kevin Mullin
"We've made great strides in the last decade getting more and more people insured and we're down to a little over three percent uninsured and I don't think we want to start walking backwards," said Mullin.
UVM political science professor Eileen Burgin says the loss of young, healthy people from the insurance market will have a long term impact on premiums for people who keep their coverage.
"If you have healthier people not signing up because there isn't a mandate that they get insurance the premiums, the CBO is estimating the premium in the individual market are going to increase by about ten percent in most years," said Burgin.
And Burgin says the insurance companies agreed to cover pre-existing conditions in return for having an individual mandate. Without the mandate, she says people can wait to sign up for insurance until they get sick.
"If you have healthier people not signing up because there isn't a mandate that they get insurance the premiums, the CBO is estimating the premium in the individual market are going to increase by about ten percent in most years."—UVM political science professor Eileen Burgin
"They weren't going to be able to just cover people with pre-existing conditions if they weren't able to increase the pool of people they insure with healthier people who are going to cost less," said Burgin.
Burgin is also concerned that some Vermonters who qualify for the state's expanded Medicaid program won't realize that they are eligible if the individual mandate is dropped.
Senate Republican leaders hope to schedule a vote on the tax bill by the middle of December.
But the outcome of that vote is uncertain because several GOP senators say they might vote against the legislation if it doesn't include a bi-partisan plan to strengthen the Affordable Care Act.
