It may take days, weeks, years, or even a decade to fully determine what the Republicans in Washington have done to the nation’s health care with the U.S. Senate’s middle-of-the-night approval of more than $1 trillion in changes to the U.S. tax code. But it will at least be big, and maybe huge.
The House and Senate still must reconcile their versions, and President Trump must agree to what lawmakers settle among themselves. So the extent of the health harms the ostensible tax bill—which many have said is really a health bill with tax cuts attached—may inflict on Americans remains up in the air, to a degree.
Millions will lose their health insurance coverage, because the tax bill repeals Obamacare’s requirement that taxpaying citizens show they have health coverage, the so-called individual mandate. Without the mandate, consumers can wait to buy insurance until they get sick, the equivalent of buying fire insurance on your house when it’s burning down. But this means insurers have to jack up rates to offset all the gaming of the system. It also opens the way to “skinny” or skimpy health plans that really offer little or no coverage for the sick or those in need of medical services.