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What happens next if the individual mandate is repealed

“Skinny repeal” was quickly rejected in the Senate. It’s back.

The “skinny repeal” vote this summer.

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In January 2012, 27 senators sent the Supreme Court a 48-page legal brief.

The Supreme Court would soon hear a landmark case on the legality of the Affordable Care Act’s individual mandate. These senators wanted to warn the justices of grave consequences of repealing the requirement to carry health coverage.

“The individual mandate,” they wrote, “is at the heart of the PPACA. The remainder of the statute necessarily depends on its inclusion because without the mandate, the statute’s reforms cannot work as intended.”

The senators who wrote this letter were (and are) Republicans. Twenty-three of them still serve in Congress — and most have been supportive of a tax bill that would unleash these exact same consequences.

Senators have not developed a sudden case of amnesia — they have not forgotten the consequences of mandate repeal. Many spoke out against the idea of stand-alone repeal of the individual mandate this summer, when a bill known as “skinny repeal" was introduced.

That bill would have, like the tax bill, repealed the requirement to carry coverage — and senators harshly attacked it as a terrible policy.

“The skinny bill as policy is a disaster,” Sen. Lindsey Graham (R-NC) said at the time. “It is not a replacement in and of itself.”

But skinny repeal is essentially what Republicans have attached to their tax bill. And that provision runs the very real risk of causing disruption and possibly collapse in the Obamacare insurance marketplaces.

What to expect when you're expecting individual mandate repeal

In Wednesday's VoxCare, I wrote about the assumptions that economists have about what would happen if the individual mandate went away. You can read more about that here. The upshot is: Premiums go up and the number of Americans with coverage goes down.

The coverage loss looks similar to what you'd see under Senate health bills, as this graph from Vox's Alvin Chang shows:

Chart of the Day

Data from the Congressional Budget Office

Kliff’s Notes

With research help from Caitlin Davis

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