President Trump on Friday declared Obamacare "over" as he signed the Republican tax bill that repeals the law's individual mandate penalties.
Repeatedly describing as "unfair" the requirement that individuals who do not purchase insurance pay a fine, Trump said of eliminating the penalties, "Essentially, I think it ultimately leads to the end of Obamacare. I think Obamacare is over because of that."
He also reiterated his vow that "we're going to come up with something that's really going to be very good."
Trump said, "The individual mandate was very unfair, because you're basically saying, pay for something in order to not have to get healthcare. So you're paying — you're paying not to have healthcare. It was very unfair. Many people thought it should have been overturned at the Supreme Court."
Republicans failed to deliver on their seven-year promise to repeal and replace Obamacare this year, but when it came time for tax reform, they rallied around repealing the individual mandate's penalties. Nixing the penalties served multiple purposes: it allowed them to tout the repeal of at least one aspect of Obamacare and it produced $338 billion of savings that could be used to help the finances of their tax reform package.
The savings mostly come from an assumption that without the requirement to purchase insurance, 13 million fewer individuals would sign up for Medicaid or claim subsidies for privately-administered Obamacare plans, thus reducing federal spending.
There is a broad debate in the healthcare policy community as to how much of a difference the elimination of the penalties will make when they stop being in effect as of 2019. Within the healthcare policy community, the thinking has traditionally been that the mandate is a central pillar of the law — a way of pushing younger and healthier individuals into the system to help offset the cost of covering older and sicker enrollees.
Without enough healthy customers, insurers could be left with only sicker individuals, which could trigger more premium increases and market exits from insurers. But in recent years, there’s been a questioning of whether the individual mandate has as significant an impact as originally thought given Obamacare’s more limited success in enrolling individuals who don’t qualify for free or near free care.
Though Trump's declared that Obamacare is "over," it just concluded an open enrollment season in which at least 8.8 million individuals signed up for coverage through the federal healthcare.gov. Though this is much lower than what CBO projected when the law was initially passed, it beat expectations, nearly equaling last years total, despite Trump cutting the open enrollment period in half and slashing the advertising and outreach budget.