In the early hours of Saturday morning, the Senate voted 51-to-49 to pass the final version of its tax bill.
Senators received the revised 479-page bill just hours before the vote took place, and amendments from Democrats calling for a delay to allow time to review the legislation were defeated, according to The New York Times.
Among the aspects of the bill that are most likely to affect health, the medical expense deduction, which was reported to be at risk, was kept in the Senate bill and increases over the next 3 years, according to The Washington Post.
The individual mandate to have health insurance or pay a penalty as required by the Affordable Care Act was removed from the Senate bill. The nonpartisan Congressional Budget Office has predicted this change would lead to a 10% annual increase in premiums, with an estimated 4 million people dropping insurance by 2019 and 13 million by 2027.
Vice President Mike Pence broke the tie to pass Senator Ted Cruz’s (R-Texas) amendment that would allow funds from 529 saving accounts to fund public, private and religious K-12 schools and home-schooled students, according to The New York Times.
A child tax credit for low-income families offered by Senators Marco Rubio (R-Florida) and Mike Lee (R-Utah) was rejected, according to The New York Times.
The New York Times also reported that the CBO estimated that the revised tax bill would cut taxes by nearly $1.5 trillion over 10 years, with several independent analyses showing most of the savings would benefit those making more than $100,000 annually.
Now, the differences between the House and Senate tax plans must be reconciled, and a conference committee may be set up as early as today, according to The Washington Post.
Before the vote, several health care organizations, including the ACP, the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and the American Psychiatric Association, have expressed alarm about the impact of the tax reform bill.
The AAFP issued a statement on Friday and told Healio Internal Medicine that its concerns remain despite the last-minute wrangling over the details of the legislation.
“The AAFP appreciates the need to reform our nation’s tax code,” the AAFP said in the statement. “However, we are growing increasingly alarmed that the tax legislation under consideration in the United States Senate ... would trigger automatic spending cuts as required by the ‘Statutory Pay-As-You-Go Act of 2010.’ These automatic, statutory cuts would significantly harm the Medicare program in the short-term and potentially eliminate the program as we know it in the long-term.” – by Alaina Tedesco
Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.