Wisconsin U.S. Rep. Ron Kind says Republicans' federal tax overhaul could impact health care access for Wisconsinites.

GOP lawmakers in Congress are still working to settle differences between a House and Senate version of their tax reform plan.

But the final version is likely to remove Affordable Care Act financial penalties for those who don't have health insurance. Without them, the insurance marketplace is expected to see less participation and higher premiums.

"There's a lot going on out here right now that has an adverse impact on health care and coverage for people," said Kind, D-La Crosse. "And those in Medicare are not immune from what’s going on."

The Republican plan would not balance tax reductions with new revenue, so Congress' "Pay As You Go" rule (often abbreviated as "pay-go") would require automatic spending cuts to federal programs, including Medicare.

"It’s happening at the wrong time,” Kind said. "We've got 70 million Baby Boomers beginning their massive retirement and joining Social Security and Medicare, 10,000 (people) a day. And there's no way we're going to be able to sustain those programs if you pile another $2 trillion worth of debt on our national credit card over the next 10 years."

Social security and other low-income programs are exempt from the rule, but a memo from the Congressional Budget Office estimates Medicare would see a $25 billion funding cut in 2018 under pay-go.

But House Speaker Paul Ryan said leadership would pass legislation to waive the pay-go cuts.

"Critics of tax reform are claiming the legislation would lead to massive, across-the-board spending cuts in vital programs — including a four percent reduction in Medicare — due to the pay-go law enacted in 2010. This will not happen," said Ryan in a statement issued last week. "Congress has readily available methods to waive this law, which has never been enforced since its enactment. There is no reason to believe that Congress would not act again to prevent a sequester, and we will work to ensure these spending cuts are prevented."