We know that you have read or heard a lot about the tax reform proposals being considered by Congress. Both the House and Senate plans provide big tax breaks for the very wealthy, raise taxes for as many as one third of the middle class and eliminate many important tax deductions — such as the medical deduction — while raising the national debt by $1.5 trillion. You’ve also heard the proposals will inevitably lead to very large cuts to Medicaid, Medicare and Social Security.

Unfortunately, the bad news doesn’t stop there.

This week, in yet another attempt to gut the Affordable Care Act (ACA), the Senate added a provision to the tax bill that would repeal the ACA’s requirement for individuals to obtain health insurance or pay a fee  — also known as the individual mandate.  Eliminating this mandate would fundamentally disable the structure of the ACA and increase the cost of health insurance at a disastrous rate.

It is rare to see consumer groups, the American Medical Association and America’s Health Insurance Plans all agree so strongly on a policy initiative. But all concur that repealing the mandate is a terrible idea.  The strength of the insurance market place is based on widespread participation.  All of us agree to pay in now so that we can have insurance when we need it. Every type of insurance works this way — homeowners, auto insurance and workers’ compensation insurance.

The ACA was built on the premise that insurance carriers could cover pre-existing conditions without raising the cost of insurance for those with such conditions so long as everyone was required to have health insurance.

No insurance company can afford to cover only people who have substantial claims. Carriers cannot remain viable if healthy people wait until they get sick to purchase insurance. We all need to participate in order to make insurance and particularly coverage of preexisting conditions affordable.

The Congressional Budget Office estimates that eliminating the individual mandate will result in 13 million people losing health insurance coverage nationwide and an increase of 10 percent a year over the current baseline in individual premiums.    As insurance premiums rise, will insurance carriers continue to offer coverage in the individual market — especially if the Administration keeps making it difficult for insurers to participate? Certainly insurance will be unaffordable for many seniors and people with pre-existing conditions — including those who need or want to retire early, who lose their job, try to start a new business, or need some time off because they are ill or need to care for a loved one.

We note this proposal comes at a time when, despite a gloomy prognosis for enrollment from the President, more people than ever are signing up for health insurance.  Compared to last year, almost double the number of people have enrolled during this open enrollment period, which began Nov.1. The ACA is working for many Americans.

We will keep sounding the same refrain until Congress turns its attention to what it can do to improve rather than destroy the ACA. We hope you will too.  Please call your Senators and Representatives and ask them to preserve the individual mandate.

The Senate bill includes the mandate repeal, the bill the House approved on Thursday doesn’t include the repeal of the individual mandate, but the House will consider the issue after the Senate votes. We understand the Senate will likely vote by Dec. 1.

Members of Congress stopped previous actions to undo the ACA after hearing their constituents concerns. With your help, we can stop this latest effort to destroy the ACA and work on constructive solutions to make quality health care affordable for all.

– By Elisabeth Arenales