Senate Majority Proposes the Better Care Reconciliation Act

The long-anticipated Senate majority proposed repeal to the Patient Protection Affordable Care Act (ACA) was unveiled Thursday, under a bill titled the “Better Care Reconciliation Act (BCRA).”

The bill reveal comes 2 months after the passing of House of Representatives’ American Health Care Act (AHCA) in May — with similar changes to the ACA occurring in both bills.

The Senate Republicans’ BRCA similarly calls for spending cuts to the ACA — known informally as “Obamacare” — and elimination of many of its taxes. It also calls for an elimination of the employer mandate to affordable coverage to employees, like the AHCA before it.

The 2 bills additionally call for an end to cost-sharing subsidies to aid ACA customers’ deductibles and copayments by 2020, and Planned Parenthood would face a 1-year freeze under its Medicaid funding.

In both majority party bills, there is a proposal to convert Medicaid from an entitled program under the ACA, to a state per capita or block grant program. States would also be entitled to change the qualifications of essential health benefits under either bill.

The BCRA does deviate from the preceding majority bill in certain aspects. The Senate bill proposes disallowing insurance companies from increasing premiums or deny coverage based on preexisting conditions, similarly to the ACA’s ruling.

The bill also calls for the elimination of individual mandate — a deviation from the ACA’s requirement for most Americans to have health coverage, or the AHCA’s allowance of insurers’ premium surcharges on new healthcare plans started after a lapse of coverage.

States that expand Medicaid coverage under the BCRA would receive a smaller portion of federal funding starting in 2021 when compared to the ACA, whereas the ACHA disallows the expansion of Medicaid after this year.

The drafted bill is anticipated to reach the Senate floor next week, where it could eventually come to vote and influence a massive change of the state of the US health care system.

Senate majority leader Mitch McConnell (R-KY) told The New York Times on Wednesday the status quo under the ACA is “completely unacceptable and totally unsustainable.”

“Prices are skyrocketing, choice is plummeting, the marketplace is collapsing, and countless more Americans will get hurt if we don’t act,” McConnell said.

Chuck Schumer (D-NY), the Senate minority leader, called the proposed BCRA a “wolf in sheep’s clothing” in a speech at Capitol Hill Thursday morning.

He noted President Donald Trump’s previous description the passed House bill as “mean,” noting the Senate bill may be meaner.

"The way this bill cuts healthcare is heartless," Schumer said.

An electronic copy of the proposed bill is available online.

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