The following Tulane University experts are available to discuss the GOP health plan and efforts to change the so-called Johnson Amendment that revokes tax exemptions for religious organizations and churches that endorse or oppose political candidates.


Health policy expert Mark Diana, associate professor in health systems management, can discuss the potential impact of health care reform plans. 

Diana said the following about the current proposal:

“Republicans in Congress and President Trump have amended the bill to attract support from the more conservative Republicans in the House. These amendments allow states the ability to opt out of requiring coverage for pre-existing conditions, and would place individuals with pre-existing conditions in high-risk pools. High-risks pools have been tried in the past and they have a mixed record of success.

The amendments also include $8 billion in additional money to pay for the health care these individuals would need, bringing the total support for people with pre-existing conditions to roughly $150 billion over 10 years. Some estimates are that the actual cost will be closer to $300 billion over 10 years. Beyond that, all of the previous changes are in this version that were in the previous version, which was estimated to result in 24 million individuals losing health insurance. That estimate will not go down with these amendments, and will likely increase instead.

If this version of the repeal and replace effort is not successful (and it seems unlikely to pass the Senate even if the House passes it), Republicans and the Trump Administration will have to decide to what extent they either support the Affordable Care Act, or whether they try to undermine its provisions.

One key question is whether they will pursue the effort to remove the subsidies that the government provides low-income individuals that make purchasing insurance affordable. If they remove those subsidies, not only will millions of individuals likely not be able to afford insurance, but insurance companies will find it difficult to remain profitable in the exchanges. Keeping insurers in the exchanges is a key element of continued success of the ACA. Beyond the subsidies, approaches like re-insurance can help stabilize high risk markets. Democrats would likely support efforts to improve the ACA, such as ensuring premium subsidies continue or implementing re-insurance, but it’s not clear the President or Congress is willing to work in a bipartisan fashion.”

Mark L. Diana, associate professor and chair of Health Systems Management
Tulane University School of Public Health and Tropical Medicine
Email:  [email protected]



Tulane University law professor Keith Werhan is available to comment about efforts to undermine the Johnson Amendment which prohibits tax exempt religious organizations from endorsing political candidates.

Werhan specializes in constitutional law, particularly the First Amendment, freedom of speech and religion clauses.  

Werhan said the following regarding the Johnson Amendment:

“Ironically, the Johnson Amendment, although introduced by Lyndon Johnson, was enacted by a Republican Congress and was signed into law by President Eisenhower. It has remained on the books since 1954, well over half a century ago.

The Johnson Amendment changed the Internal Revenue Code to provide that nonprofit organizations could lose their tax-exempt status if they participated in elections by endorsing or opposing candidates, making campaign contributions, and the like.

Although there is record of only one church losing its tax-exempt status because of the Johnson Amendment (this occurred in 1995), the stated intention of President Trump and supporters in Congress is to free clergy to endorse or oppose candidates from the pulpit.

It must be remembered that the religion clauses of the First Amendment do not permit Congress to single out churches and other religious organizations for special tax treatment, whether favorable or unfavorable in nature. The Johnson Amendment applies to all nonprofits that enjoy tax-exempt status, and any repeal of the Johnson Amendment would have to apply on religiously neutral terms to all nonprofits as well.

It also should be noted that nonprofits, religious organizations and their clergy, may speak out freely on political and social issues without fear of violating the Johnson Amendment. And indeed, religious organizations and clergy have played a prominent role in the civil rights movement and in anti-war movements, and they have played an equally prominent role on both sides of the debates over abortion and equality for LGBT members, as well as countless other issues.

The Johnson Amendment simply provides that tax subsidies should not support electoral activity by nonprofits. Members of Congress should think long and hard before deciding that they should subsidize some participants in the electoral process (nonprofits) and not others (everyone else).”


Keith Werhan, Ashton Phelps chair of constitutional law
Tulane University Law School
Email:  [email protected]