Dear Mr. Austin:
Thank you for taking the time to contact me about the individual responsibility fee established by the Affordable Care Act. I appreciate hearing from you about this issue.
Health insurance is a shared responsibility, and the Affordable Care Act ensures that all Americans have access to affordable health insurance in several ways. Individuals are responsible for purchasing health insurance, employers are responsible for providing health insurance and the federal government ensures that all Americans can afford health insurance. The Affordable Care Act includes provisions to help low- and moderate-income individuals and families buy insurance and it makes it easier for small businesses to provide coverage for their employees. The requirement to purchase health insurance took effect in 2014 and is enforced with a modest individual responsibility fee assessed to individuals who choose not to purchase health insurance.
There have been proposals to either repeal the individual responsibility fee or to create new exemptions from it, and the Senate majority’s tax bill contained a provision to reduce the individual responsibility fee to zero in 2019, effectively eliminating it. However, one intent of the individual responsibility fee is to help avoid the problem of “adverse selection,” which would occur if only those individuals who are sick sign up for health insurance coverage, while those who are healthy opt out of coverage. This would ultimately drive up costs for everyone.
Unfortunately, when the majority’s tax scheme was signed into law in December, it still contained the provision eliminating the individual responsibility fee. This is one of the many reasons I voted against the tax package, as this provision will result in 13 million Americans losing their health care and premium increases of 10 percent per year over the next decade. That increase in premiums would be on top of the average 30 percent increase that has already taken place in Pennsylvania due to deliberate efforts to sabotage the law by the Trump Administration. Undermining access to health insurance for middle-class Pennsylvanians is wrong, which is one reason why I opposed eliminating the individual responsibility fee.
We have made significant strides in improving our health care system in recent years: 20 million individuals have obtained health insurance since 2010; insurance companies are no longer able to discriminate against individuals with pre-existing conditions, women or older Americans; and senior citizens have saved more than $20 billion on the cost of prescription drugs. Even so, I recognize that our health care system is far from perfect and that too many Americans continue to pay too much for their health care and prescription drugs. More work needs to be done, and I am hopeful that the majority and the minority might come together to seek further improvements to bring down the cost of care and to improve its quality.
I am actively working on commonsense solutions to improve our health care system. I recently joined several of my colleagues in introducing a bill to bring down prescription drug costs by allowing the importation of drugs from Canada. I also support creating a Medicare-like “public option” to compete with private insurance and provide consumers with more choices. I have also proposed changes to the Affordable Care Act itself, such as making it easier for families to access the law’s tax credit for health insurance when one spouse already has insurance at work.
We must continue as we did in the fall of 2017, when Senator Lamar Alexander of Tennessee and Senator Patty Murray of Washington drafted bipartisan legislation I supported to stabilize the individual health insurance market. Those efforts followed a series of hearings in the Committee on Health, Education, Labor, and Pensions, where we heard from a bipartisan group of elected officials, state insurance commissioners, insurers and health care providers. Sadly, the future of that legislation has been cast into doubt by the passage of the tax bill, but I will continue looking for ways to work across the aisle to improve our health care system.
Again, thank you for sharing your thoughts with me. Please do not hesitate to contact me in the future about this or any other matter of importance to you.
For more information on this or other issues, I encourage you to visit my web site,
http://casey.senate.gov. I hope you will find this online office a comprehensive resource to stay up-to-date on my work in Washington, request assistance from my office or share with me your thoughts on the issues that matter most to you and to Pennsylvania.
Sincerely,
Bob Casey
United States Senator
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