Trump Eliminates Affordable Care Act's Insurance Mandate Inside Tax Bill, Resolving Long-Standing Concern That The Health Law Senate Republicans Failed To Repeal Was Still Standing

WASHINGTON. President Donald Trump on Friday signed a $1.5 trillion tax bill that, in addition to its many provisions concerning corporate rates and pass-through deductions, quietly reduced to zero the financial penalty for going without health insurance, a maneuver the administration described as the long-awaited repeal of the Affordable Care Act. Senate Republicans had spent the previous summer attempting to repeal the law directly and had failed by a single vote, but officials confirmed that the requirement at the law's center had since been located inside an unrelated piece of tax legislation, where it could be removed without a single additional health care vote.

The provision in question, known as the individual mandate, had required most Americans to carry coverage or pay a penalty at tax time. Health policy analysts had long described the mandate as the mechanism that kept healthier people enrolled alongside sicker ones, an arrangement that allowed insurers to spread costs and hold premiums down for the pool as a whole. By setting the penalty at zero, the administration freed healthy Americans from the obligation of carrying insurance before they were sick, an obligation many had reported finding inconvenient.

Trump celebrated the change as the effective end of the law, telling reporters at the White House that the country had moved past the Obama-era system entirely. "We have essentially repealed Obamacare," the President said, "and we will come up with something that will be much better." Administration officials noted that the something in question was in active development and would be unveiled at the appropriate time.

The Congressional Budget Office projected that zeroing out the penalty would result in roughly 13 million fewer Americans carrying insurance within a decade and would raise premiums in the individual market by about 10 percent in most years, as healthier customers exited and the remaining pool grew older and sicker. A source within the administration characterized these figures as evidence the policy was functioning correctly, explaining that a mandate no one was required to follow was, by any reasonable measure, a mandate successfully addressed.

Legal observers noted that the change carried a second use beyond the immediate one. With the penalty reduced to zero, the mandate could be described in court as a command backed by no consequence, and therefore, the argument would run, no longer a valid exercise of the taxing power the Supreme Court had relied on to uphold the law in 2012. Within months, a coalition of eighteen Republican attorneys general would file suit on precisely that theory, seeking to have the entire Affordable Care Act declared unconstitutional. The administration had not merely removed the mandate; it had reshaped it into a key.

At press time, the replacement health care plan that would be "much better," first promised during the 2016 campaign, remained, as it had every week since, approximately two weeks from release.