Voices of Alaska: Repealing health care mandate restores freedom to choose

  • By Sen. Lisa Murkowski
  • Tuesday, November 21, 2017 11:54am
  • OpinionOpinion

I have always supported the freedom to choose. I believe that the federal government should not force anyone to buy something they do not wish to buy, in order to avoid being taxed. That is the fundamental reason why I opposed the Affordable Care Act from its inception and also why I cosponsored a bill to repeal the individual mandate tax penalty starting as early as 2013. And that is why I support the repeal of that tax today.

Over the course of this year, the Senate has considered bills that would have repealed Medicaid expansion, completely transformed the base Medicaid program, converted the individual exchanges into a block grant program, cut Planned Parenthood out of Medicaid reimbursement for a year, and other measures. All of those bills went far beyond the fundamental problems presented by the ACA, and would have unnecessarily taken away access to care from those who need it most.

The ACA has helped many people in our state, and across the country. There is no question about that. Some people have been able to buy insurance for the first time in their life, mental health and substance abuse coverage is more accessible now, and insurers cannot arbitrarily deny coverage to those with pre-existing conditions. I do not support taking care away from these people, but there are many for whom this law has not helped. It is important to emphasize that eliminating this tax penalty does not take care away from anyone. Instead, it provides important relief to those who have been penalized for choosing not to buy unaffordable insurance.

Alaskans pay the highest price for premiums in the country; that is why the number of people enrolled on the exchange in Alaska has shrunk every year since the ACA was passed. People have been forced out of the market by the high cost of insurance, with some often forced to pay a tax because the price of insurance was too high for them to afford.

A silver plan for a family of four, with a $9,000 deductible, will cost about $2,160 per month in 2018. If this family does not qualify for the advanced premium tax credits, they face the choice of paying almost $35,000 in 2018 just for health insurance premiums, before their insurance really kicks in, or potentially paying a tax of $695 or 2.5% of their income. An individual could be paying around $709 per month for a plan with a $3,000 deductible. With no tax credits, that person would pay over $11,500 per year before insurance starts to help, or pay the tax for not having coverage.

Alaskans paid over $9 million to the IRS under this penalty in 2014, and over $12 million in 2015. There are Alaskans making the calculated risk to go without insurance and pay the tax. They prefer to take a gamble, pay for care out of pocket, and hope nothing too bad happens because the insurance available to purchase is unaffordable. Eliminating this tax would allow Alaskans to have greater control over their money and healthcare decisions.

Repealing the individual mandate simply restores to people the freedom to choose. Nothing else about the structure of the ACA would be changed. If you currently get tax credits to help pay for your insurance, you could still receive those credits if you choose to buy an exchange plan. If you are enrolled on Medicaid, or received coverage under Medicaid expansion, you could still be enrolled if you choose to be. The only difference would be is if you choose to not buy health insurance, the government would not levy a tax on you.

Protecting the gains we’ve made with provisions of the ACA while providing greater control to states and options for individuals is why I have been working for bipartisan solutions to the healthcare challenges we face. Instead of taxing people for not being able to afford coverage, we should be working to reduce costs and provide options. That is precisely what the bipartisan legislation introduced by Senator Alexander (R-Tennessee) and Senator Murray (D-Washington), which I have cosponsored, achieves.

While I support repealing the individual mandate, I strongly support enacting the bipartisan compromise Alexander/Murray into law as fast as possible to stabilize our markets, provide more control to states and more choices to individuals.

Lisa Murkowski represents Alaska in the United States Senate.

More in Opinion

(Juneau Empire file photo)
Opinion: Life is harder when you outlive your support group

Long-time friends are more important than ever to help us cope, to remind us we are not alone and that others feel the same way.

A silver salmon is weighed at Three Bears in Kenai, Alaska. Evelyn McCoy, customer service PIC at Three Bears, looks on. (Photo by Jeff Helminiak/Peninsula Clarion)
Opinion: Will coho salmon be the next to disappear in the Kenai River?

Did we not learn anything from the disappearance of the kings from the Kenai River?

Jonathan Flora is a lifelong commercial fisherman and dockworker from Homer, Alaska.
Point of View: Not fishing for favors — Alaskans need basic health care access

We ask our elected officials to oppose this bill that puts our health and livelihoods in danger.

Alex Koplin. (courtesy photo)
Opinion: Public schools do much more than just teach the three Rs

Isn’t it worth spending the money to provide a quality education for each student that enters our schools?

Gov. Mike Dunleavy speaks to reporters at the Alaska State Capitol on Thursday, April 17, 2025. (Jasz Garrett / Juneau Empire file photo)
Letter to the Editor: Law enforcement officers helped ensure smooth, secure energy conference

Their visible commitment to public safety allowed attendees to focus fully on collaboration, learning, and the important conversations shaping our path forward.

Laurie Craig / Juneau Empire file photo
The present-day KTOO public broadcasting building, built in 1959 for the U.S. Army’s Alaska Communications System Signal Corps, is located on filled tidelands near Juneau’s subport. Today vehicles on Egan Drive pass by the concrete structure with satellite dishes on the roof that receive signals from NPR, PBS and other sources.
My Turn: Stand for the community radio, not culture war optics

Alaskans are different and we pride ourselves on that. If my vehicle… Continue reading

U.S. Sen. Dan Sullivan (R-Alaska) delivers his annual speech to the Alaska Legislature on Thursday, March 20, 2025. (Jasz Garrett / Juneau Empire file photo)
Opinion: Sullivan, Trump and the rule of lawlessness

In September 2023, U.S. Sen. Dan Sullivan established his own Alaska Federal… Continue reading

UAA Provost Denise Runge photographed outside the Administration and Humanities Building at the University of Alaskas Anchorage. (courtesy photo)
Opinion: UAA’s College of Health — Empowering Alaska’s future, one nurse at a time

At the University of Alaska Anchorage, we understand the health of our… Continue reading

U.S. Rep. Nick Begich III, R-Alaska, address a joint session of the Alaska Legislature on Thursday, Feb. 20, 2025. (Mark Sabbatini / Juneau Empire file photo)
Opinion: A noncongressman for Alaska?

It’s right to ask whether Nick Begich is a noncongressman for Alaska.… Continue reading

Boats return to the Homer Harbor at the end of the fishing period for the 30th annual Winter King Salmon Tournament on Saturday, March 23, 2024 in Homer, Alaska. (Delcenia Cosman/Homer News)
Opinion: Funding sustainable fisheries

Spring is always a busy season for Alaska’s fishermen and fishing communities.… Continue reading

Gov. Mike Dunleavy holds a press conference on Monday, May 19, 2025, to discuss his decision to veto an education bill. (Jasz Garrett / Juneau Empire file photo)
Opinion: On fiscal policy, Dunleavy is a governor in name only

His fiscal credibility is so close to zero that lawmakers have no reason to take him seriously.