GOP seeking 5-year mandate delay

House Republicans are considering a bill this week that delays the enforcement of ObamaCare's individual mandate penalties for five years and uses the savings to prevent a cut in Medicare doctor payments for 10 years.

The two ideas are likely to be combined into a single bill: the Sustainable Growth Rate Repeal and Medicare Provider Payment Modernization Act, H.R. 4015. That bill repeals cuts to physician payments and allows for small increases over 10 years.

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Republicans were expected to offer an amendment to that bill to pay for this spending by ending the mandate penalties. Late Tuesday, the Congressional Budget Office (CBO) released a score for an amendment from Ways and Means Committee Chairman Dave Camp (R-Mich.) to end the penalties for five years.

According to the CBO, Camp's amendment would cut spending by $170 billion, enough to pay for the $138 billion "doc fix."

The CBO also said Camp's language would increase the number of people without health insurance by 13 million people in 2018. But that is likely the cause of the savings, as failing to enforce the individual mandate also means the government spends less in subsidies to help people buy insurance.

The analysis also said premiums would increase 10-20 percent on the individual market during "most" of the years without a mandate penalty.

Democrats are likely to oppose the GOP plan as one that would make it harder for people to get health insurance. Last week, House Minority Whip Steny Hoyer (D-Md.) indicated Democrats would oppose the GOP plan language.

Hoyer also said that adding language on the individual mandate to the doc fix bill could raise the chance that Congress fails to act on the doc fix by the end of the month, when new cuts to physician payments are due to take effect.

"[T]here hasn't been agreement in the past, and if we use that [the individual mandate] as a pay-for, it seems to me it puts at risk meeting the March 31 deadline," Hoyer said.

Consideration of the House bill comes in the same week that The Wall Street Journal reported that the Obama administration has quietly decided to allow people not to buy insurance if newly available plans are too expensive. This exemption from the mandate would last for two years, until 2016.