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Health care advocate concerned tax bill focuses on “cutting benefits rather than on cutting costs”

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“I am concerned that the focus is going to be on cutting benefits rather than on cutting costs, and particularly benefits for the most vulnerable," Udow-Phillips said about the new tax plan.";



As he prepares to sign the newly-passed GOP tax bill, President Trump saluted the measure  by claiming it fulfills his campaign promise to repeal the Affordable Care Act (ACA).


The bill does away with the individual mandate that was a central component of the ACA.


Marianne Udow-Phillips from the Center for Healthcare Research and Transformation joined Stateside to give her take on how the tax bill might impact healthcare.


Listen above for the full conversation, or catch highlights below.


On the repeal of individual mandates


There's no question that removing the individual mandate has resulted in some assessments that it will reduce government spending, and it's because fewer people will get health insurance. Fewer people who get health insurance, some of them because they aren't required to — and that's the argument on the Republican side is you shouldn't require people to have health insurance — but some of them won't get it because it will become unaffordable. The whole reason for the individual mandate is frankly to encourage healthy people to get coverage so it makes the cost of healthcare more affordable for everybody.


The estimate from the Congressional Budget Office is that removing the mandate by itself will raise premiums by ten percent. We already saw an almost 30 percent increase in premiums this year because of the lack of payment for the cost-sharing reduction payments that are owed to health plans, and because of just natural increases in health care costs. So, this is another increase on top of that, and unfortunately, that could make health insurance really unaffordable, particularly for middle-class people.”


On insurers leaving the market


There are a lot of people who are concerned that we'll have more health plans exiting the market because they're very concerned that the market will become unstable. Now, we don't know that that's going to happen. Michigan this year and going into 2018, we still have a robust market. We have nine insurers that stayed even with a lack of payment for cost-sharing. So, Michigan has been really resilient with all these efforts to frankly undermine the Affordable Care Act, but I think it's likely we'll see more insurers leave the market next year with the individual mandate going away.”


On the numbers


Our enrollment in Michigan was well ahead of where we were the year before at the same time. So, about by December 10, about 153,000 people had enrolled in coverage in Michigan, and that's 20,000 more than had enrolled in the prior year at the same time.”


On tax deductions


Under current tax law, you can deduct medical expenses if they exceed ten percent of your income. The Conference Committee Report reduced that amount to 7.5 percent of your income, and that could mean that either more people can take deductions for medical expenses or more expenses can be deducted for people who have very high medical expenses. In 2015, about 235,000 people in Michigan took those deductions, so it could affect a lot of people, and some people could be benefited. We could have more people eligible for that tax deduction.”


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