Senate Leader Mitch McConnell (R-Ky.) July 13 released an updated version of the Better Care Reconciliation Act of 2017 (BCRA). The revised bill, aimed at alleviating the concerns of both moderate and conservative Senators, continues to meet with vigorous pushback from the public at large and stakeholder groups.
In a statement, AAMC President and CEO Darrell G. Kirch, MD, said, “Notwithstanding the widespread concerns with the original Better Care Reconciliation Act, the revised bill released today still falls woefully short in providing Americans with comprehensive, affordable health coverage, and will leave millions without any coverage at all…The changes do nothing to address provisions that would cripple Medicaid and put added financial pressure on state budgets and health care providers. Additionally, allowing insurers to sell plans without meaningful coverage will hurt those with preexisting conditions and further destabilize insurance markets. Finally, providing time-limited money to help individuals purchase insurance does not give patients the long-term health security they need.”
The revised version of the bill provides more funding to cover out-of-pocket health care costs, allows individuals to use Health Savings Accounts (HSA) to pay for premiums, and sets forth additional resources to combat the opioid epidemic. The bill also maintains cuts to the Medicaid program and keeps intact the ability of states to waive various consumer protections, including the essential health benefits requirements. The bill also includes a provision drafted by Senator Ted Cruz (R-TX) that would enable insurers to sell non-compliant plans alongside Affordable Care Act (ACA) plans on the Exchanges. Individuals would also be able to pay for these plans using their tax credits.
The opposition to the bill continues, as Senators from both parties raise doubts as to whether they will support the legislation. Senate Finance Committee Ranking Member Ron Wyden (D-Ore.) said in a statement, “Trumpcare is still about raising health costs for middle-class families, giving tax breaks to special interests, and keeping the deep cuts to Medicaid that threaten vulnerable Americans across every generation. By including the Cruz amendment, Senate Republicans are prescribing health care chaos by isolating Americans with pre-existing conditions and forcing them to pay astronomical costs to get the care they need.”
A vote on the legislation could come as early as next week, although two Republican Senators – conservative Rand Paul (R-Ky.) and moderate Susan Collins (R-Maine) – announced they would oppose a motion to debate the revised bill. If one more Republican Senator were to join them, the Senate could not even debate the legislation, much less amend or vote on it. A revised Congressional Budget Office (CBO) score is also expected to be released next week. Senator McConnell has indicated that the Senate will remain in session for the first two weeks of August to continue working on health care and other matters.