Sens. Pat Toomey, Tom Cotton introduce bill that offers exemptions to ACA's individual mandate

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Two GOP senators have introduced a bill that would create exemptions to the individual mandate.

Two Republican senators have introduced a bill that would exempt some people from the Affordable Care Act's individual mandate. 

Pennsylvania Sen. Pat Toomey and Arkansas Sen. Tom Cotton introduced the Mandate Relief Act on Tuesday, which would allow for three exemptions to the mandate: 

  • For people who earn less than the median national income
  • For people who live in states where premiums increased by more than 10% year over year
  • For people who live in counties covered by just one individual market insurer

The bill would also remove ACA penalties related to health savings accounts and health reimbursement arrangements, the senators said. 

The individual mandate is one of the central pillars of the ACA's insurance reforms, and is designed to encourage younger, healthier people to purchase insurance, thus balancing risk and lowering costs. Advocates have argued that failing to enforce the mandate could further destabilize the markets.  

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In an accompanying op-ed published by Fox News, Toomey and Cotton called the individual mandate one of the ACA's "cruelest provisions," arguing that many low-income Americans cannot afford to get insurance as premiums rise in the individual marketplaces. 

"The majority of well-off families get insurance through their employer, so for them, the mandate is irrelevant," the senators said. "But for those who must buy insurance on Obamacare's exchanges—where premiums have doubled since the law's passage—the mandate penalty ends up being a bargain."

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The Mandate Relief Act was introduced in the Senate on the same day that Sen. Lamar Alexander, R-Tenn., and Sen. Patty Murray, D-Wash., said they had reached a bipartisan deal to stabilize the ACA exchanges.  

President Donald Trump initially seemed to support for the measure, which would fund cost-sharing reduction payments for two years, despite deciding to cut off funding for the subsidies last week. Trump changed his tune again Wednesday morning in a tweet that said he "can never support" bailing out insurance companies that "have made a fortune" on the ACA.