Republicans are on the verge of achieving one of biggest policy goals of the past decade: unraveling the Affordable Care Act.
The Tax Cuts and Jobs Act, as being considered in the US Senate, repeals Obamacare's individual mandate. That change, according to the Congressional Budget Office, would cut $338 billion over 10 years from Medicaid and insurance subsidies and lead to 13 million fewer people having health coverage. That will, according to the best evidence we have, lead to an increase in preventable deaths on the order of 15,600 people per year.
It will do more than that, though. It will completely destabilize the market for individual health insurance. The individual mandate serves a critically important function for people buying health insurance outside of an employer. It makes sure that young and healthy people with low health expenses buy insurance, which lowers premiums for everyone else. That ensures that people with chronic health conditions who don't get insurance from work can buy coverage at an even barely reasonable price.