Tinkering with the subsidy and mandate requirements

[rob in cal]

Assuming you had a GOP president, house of rep, and a tiny majority in the senate, I wonder if the GOP would try to roll back the subsidy going to those forced to buy insurance, and on the other hand, make the individual mandate much less expensive by allowing for a bare bones, very high deductible, catastrophic only plan.  Would such a move require a fillibuster proof majority, or wouldn't it be just part of the annual budget writing process?

[muon2]

Since the mandate has been ruled a tax, then I see no reason that adjustments couldn't be made as part of a budgetary process.

[Mr. Morden]

Yes, since the mandate is a tax, they could use reconciliation to ditch the mandate without being able to be stopped by a fillibuster.  But presumably, it couldn't be used to ditch the ban on discriminating against those with preexisting conditions.  The insurance companies will lobby furiously not to ditch the mandate alone.  Whereas if the mandate had been struck down by SCOTUS, the GOP wouldn't have to worry about that, because the court would have done their dirty work for them.

[milhouse24]

Yes, since the mandate is a tax, they could use reconciliation to ditch the mandate without being able to be stopped by a fillibuster.  But presumably, it couldn't be used to ditch the ban on discriminating against those with preexisting conditions.  The insurance companies will lobby furiously not to ditch the mandate alone.  Whereas if the mandate had been struck down by SCOTUS, the GOP wouldn't have to worry about that, because the court would have done their dirty work for them.

Even if the mandate is ditched, health care companies can still raise the premium prices to offset the risk of preexisting conditions.  Are the health care companies bound by making their premiums "actually affordable"  are they restricted in price increases by the new law?

[anvi]

Though deemed constitutional as a tax, the mandate is still unpopular.  They might be able to ditch it in exchange for means-tested subsidies or something.  If that were the only challenge, there may not be much difficulty.  But the tricky part would be getting rid of guaranteed issue (which is really popular) if they wanted to ditch community rating.  That's why I now tend to think that they could modify the community rating policy so as to allow for implicit rating by insurance companies.