With no luck repealing Obamacare outright since they gained control of both the legislative and executive branches, Republicans in Congress have turned to tax reform with their fourth attempt to undermine former President Obama's signature health care bill. If they succeed, Republicans could usher in a "death spiral" for insurance markets, affecting Americans all across the country.
Included in the tax reform bill is a provision to eliminate the individual mandate, which requires that all Americans are covered by health insurance or else pay a fine.
Without the mandate, the individual market could easily collapse into what’s known as a “death spiral,” in which healthy people flee the individual health insurance market en masse, leaving the remaining customers to just be less healthy or older people, who’d then face huge premiums.
Along with unaffordable premiums, some people could see insurers leaving markets altogether.
They’d get some help from Obamacare’s insurance subsidies, which would remain and cap premiums as a share of income for low- and middle-income people. But even that might not be enough to make the plans affordable. And if enough people quit, then insurers could stop offering plans in some areas altogether.
In the end, as many as 15,600 Americans could die as the result of lacking affordable health care.
Some of the healthy and younger people, in turn, would then grow older and sicker. Some would get potentially fatal illnesses, and without insurance they wouldn’t be able to recover.