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Despite the risks, Murkowski backs ACA mandate repeal

Health care advocates have started to see Lisa Murkowski as an important ally. That may have been a mistake.
Alaska Republican Sen. Lisa Murkowski (Photo by Chip Somodevilla/Getty Images)
Alaska Republican Sen. Lisa Murkowski

When Senate Republican leaders added the repeal of the ACA's individual mandate to their tax plan, it looked like an enormous gamble. After all, the GOP's efforts to repeal the Affordable Care Act were derailed by bipartisan opposition, and by tying tax cuts for the wealthy to health care policy, it raised the prospect of greater opposition to the latest Republican gambit.

But that only works if the GOP senators who helped rescue the health care system over the summer are willing to do so again now. Evidently, that may not be the case.

Sen. Lisa Murkowski (R-Alaska) said she would support repealing the Affordable Care Act's individual insurance mandate, giving a potential boost to the Republican effort to pass a massive tax cut package next week."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," Murkowski wrote in an opinion piece published Tuesday by the Fairbanks Daily News-Miner.

Let's back up for a minute in order to better understand the landscape here. The original Republican plan was to overhaul the federal tax code in order to benefit the wealthy and corporations, but the effort ran into trouble when GOP officials couldn't get their numbers to add up. They needed more money to cover the cost of a permanent corporate tax break.

At Donald Trump's urging, Republicans determined they could repeal the "Obamacare" individual mandate and have an additional $338 billion over the next decade to pay for more tax breaks. As we discussed a couple of weeks ago, for the right, this represented the best of both worlds: the GOP could gut the health care law they love to hate, and at the same time, they could redirect that money to finance tax cuts.

There was, however, a catch: the nonpartisan Congressional Budget Office explained to lawmakers that repealing the ACA's individual mandate would destabilize the insurance market, force many consumers to pay higher premiums, and end coverage for 13 million Americans over the next decade. Hospitals, doctors, and insurers all said this was a very bad idea.

The result was effectively a caricature of Montgomery Burns-style policymaking: Republicans are pursuing a plan that would leave millions of families without health security, disproportionately hurt the poor, all in the hopes of redistributing wealth from the bottom up.

As of yesterday, Lisa Murkowski isn't yet prepared to say no to this.

On the contrary, even after being told about the consequences of repealing the ACA's individual mandate, she thinks the idea has merit.

Now, in fairness, there are important nuances to the Alaska Republican's position. Murkowski has also said, for example, that she'd like to see the Alexander-Murray compromise measure on market stabilization pass before her party's tax gambit goes through. This wouldn't fully mitigate the damage done by a mandate repeal, but she at least appears to be thinking about how best to prevent a GOP-imposed disaster.

That said, as 2017 has progressed, health care advocates have started to see Lisa Murkowski as an important ally in the fight against regressive and dangerous changes. Her comments this week put those advocates' confidence in doubt.