The House and Senate approved the Tax Cuts and Jobs Act today, and President Trump is expected to sign it soon. Here is a statement on the implications of the legislation from Sandra R. Hernández, president and CEO of the California Health Care Foundation.

The bill Congress just passed is framed as a tax bill. Make no mistake: It is very much a health bill, one that threatens the well-being of Americans for a generation.

The legislation repeals the individual mandate, a core provision of the Affordable Care Act. The Congressional Budget Office estimates that this one change alone will mean both higher premiums for Americans who buy their insurance on the individual market, and as many as 13 million more uninsured Americans by the end of the next decade. In California, it is projected to increase the number of uninsured by 1.8 million if no state action is taken to mitigate these effects.

The bill also spends a trillion and a half dollars of federal revenue with almost no tangible public good to show for it. It does not invest in any infrastructure. It won’t help reverse the opioid epidemic. It does nothing to develop the workforce for the future. What it will do is worsen inequality in our country and create a huge hole in the budget. Some Republican leaders are already making it very clear that they intend to use the budget hole — that their tax bill created — to seek deep cuts to safety-net programs, starting with Medicaid.

No one should forget that this legislation was a deeply unpopular proposal that passed with little transparency or due diligence — and no bipartisanship. When the consequences are felt, people need to remember that the damage wasn’t inherited. It was engineered.

About the California Health Care Foundation