Lisa Murkowski supports repealing Obamacare mandate

Sen. Lisa Murkowski says she supports repealing Obamacare’s individual mandate to hold insurance, giving a notable thumbs up to a contentious piece of President Trump’s tax overhaul, though she stopped short of a full endorsement of the tax plan.

Ms. Murkowski, an Alaska Republican who helped sink the GOP’s Obamacare repeal efforts over the summer over fears of hurting Medicaid or Planned Parenthood, says the mandate is a fair target.

“I believe that the federal government should not force anyone to buy something they do not wish to buy in order to avoid being taxed,” she wrote in an op-ed for the Fairbanks Daily News-Miner.

GOP Senate leaders have included a repeal of the individual mandate in their latest tax-cut plan, freeing up hundreds of billions of dollars the government no longer has to pay in Obamacare subsidies and using the cash to cut tax rates even further.

Ms. Murkowski didn’t endorse the overall plan, but the op-ed seemed to lay the groundwork for Ms. Murkowski to support the bill, disappointing Democrats who had been counting on GOP moderates like Ms. Murkowski and Sen. Susan Collins, Maine Republican, to rebuff the package.

They, along with Sen. John McCain, Arizona Republican, joined Senate Democrats to tank the Obamacare repeal earlier this year.

Ms. Collins has expressed concern over undermining Obamacare in the tax bill, but Mr. McCain has praised the process and Ms. Murkowski’s stance have boosted the GOP’s efforts.

The Senate Finance Committee approved a tax-cut bill on a party-line vote last week, after adding the repeal of the individual mandate. The full House approved its own tax-cut bill, but that measure does not touch the Obamacare mandate.

Differences will have to be reconciled in a conference before Christmas, if the Senate passes its own bill soon.

White House officials said they’re ready to drop repeal of the mandate if it becomes an impediment, though Ms. Murkowski’s position seems to suggest an easier path.

The senator argued people will still be able to tap into Obamacare coverage and its taxpayer-funded subsidies. Those who go uncovered would be choosing to do so.

“Repealing the individual mandate simply restores to people the freedom to choose,” she wrote. “Nothing else about the structure of the ACA would be changed. If you currently get tax credits to help pay for your insurance, you could still receive those credits if you choose to buy an exchange plan. If you are enrolled on Medicaid or received coverage under Medicaid expansion, you could still be enrolled if you choose to be.”

Obamacare supporters, though, say without the mandate some Americans won’t check to see if they’re eligible for Medicaid, or won’t bother to see if they can get a cheap plan on the Obamacare exchanges.

Those supporters are keeping a close eye on enrollment figures as the latest round of Obamacare sign-ups began Nov. 1, and runs through mid-December.

So far, enrollment on Obamacare’s main portal, HealthCare.gov, is approaching 2.3 million, or well ahead of last year. Yet analysts are worried, saying the quicker pace still isn’t enough to make up for an enrollment period that’s just half as long as last year.

For her part, Ms. Collins says scrapping the mandate as part of the tax bill is a bad idea, since insurers would raise premiums under the assumption that only sicker people would remain in the marketplace.

The Congressional Budget Office estimates that 13 million fewer people will hold insurance a decade from now if the mandate is repealed, while insurers will raise rates by an average of 10 percent in most years.

The American Academy of Actuaries asked Senate leaders Wednesday to “consider the adverse consequences” of scrapping the mandate. It said failure to implement an alternative spur to get people into the markets would likely chase insurers out of certain areas, reducing competition.

“This could lead to severe market disruption and loss of coverage among individual market enrollees,” academy Vice President Shari Westerfield wrote to Senate Majority Leader Mitch McConnell and Minority Leader Charles E. Schumer.

Ms. Murkowski said the best way to stabilize the market is to pass a bipartisan deal struck by Sens. Lamar Alexander, Tennessee Republican, and Patty Murray, Washington Democrat, that would restore “cost-sharing” reimbursements for insurers — so plans, made whole, would trim rates in response — and offer cheaper “copper” plans to spur healthier people into the market. It would also give states more flexibility over how they shape their markets.