The Better Care Reconciliation Act of 2017; As it Stands Today on July 13th, 2017

The senate just unveiled the latest version of their ObamaCare repeal and replace bill (an updated version of the Better Care Reconciliation Act of 2017). TIP: See the full text of the Revised Senate Health Care Bill 7/13/17 or see a summary from NPR.[1][2]

The most significant changes are the keeping of the 3.8% investments tax and a 0.9% payroll tax increase, some increased funding for Medicaid, premiums can be paid for tax-free using an HSA, and looser regulations for insurers on selling “junk plans” (plans with cheap premiums, high deductibles, and skimpy benefits).

Although the plan has not been voted on yet, two Senators quickly stood against it, while a few more are undecided.

Sens. Rand Paul (R-Ky.) and Susan Collins (R-Maine) said they would vote against allowing debate to even start.

Meanwhile, several other Republicans, including Sens. Jeff Flake, Rob Portman, Mike Lee and John Hoeven, said they were undecided.

The bill needs 51 votes to pass, and no Democrats support the bill (as they haven’t been allowed to offer input, and they all stand against the cuts in the bill). That means the undecided GOP will still have to be swayed at the least.

One path forward, mentioned by Senate Majority Leader Mitch McConnell, would be working with Democrats and moderate Republicans to draft something that works for everyone. However, this is a problem as the newest bill is partly a product of trying to appeal to the further right conservatives who want to make sure the Medicaid cuts and Planned Parenthood defunding stays in the bill and the tax cuts stay as well.

This is of course the general problem. The newest version of the bill does away with some tax cuts, but keeps in cuts to Medicaid. Paul doesn’t like the tax cuts being taken out (and the subsidizing still in the bill), Collins doesn’t like the Medicaid cuts, and other GOP side with one or the other or both.

Meanwhile, the compromises in the latest version of the bill are likely to push as many away as they pull in.

One change is that “junk insurance” will now be allowed due to a provision backed by Ted Cruz. But the problem with that is that it will likely push the young and healthy into these low-premium, high-deductible, low-coverage plans…. thus raising the plans of the sick.

This of course means higher costs for the sick and poor, which means more subsidy spending.

For more information, seeSenate Republicans one vote away from Obamacare repeal failure from Politico.com.

A Breakdown of the Changes in the New Version of the BCRA (The Senate’s ObamaCare Repeal and Replace Plan)

The bill includes the following changes:

  • Less tax breaks for the rich (i.e. the 3.8% investments tax and a 0.9% payroll tax increases under the Affordable Care Act are retained)… taxes on industry are still cut.
  • Flexibility on Medicaid funding if a public health emergency takes place.
  • A Block grant option to allow states to add the newly eligible Medicaid population to coverage under the block grant.
  • Extra money for stabilization. $70 billion more than the first draft of the bill’s $112 billion for state-based health care initiatives to drive down premiums.
  • Extra money for high risk customers. If an insurer offers one of those plans that meets the Obamacare criteria, that insurer would be eligible for money from a fund designed to help high-risk customers, which could potentially mitigate some of the two-tier issues created by new, nonqualified plans.
  • Extra money for the opioid epidemic. $45 billion for fighting drug addiction and would ease the sale of low-premium “catastrophic” insurance plans.
  • New financial support to help low-income people purchase health insurance.
  • A provision to allow people to pay for insurance with pre-tax money via HSAs (which is great for customers who buy their health plans out-of-pocket).

Learn about everything the Better Care and Reconciliation Act of 2017 does here.

Citations

  1. Senate Republicans one vote away from Obamacare repeal failure. Politico.com.
  2. Read: full text of the Revised Senate Health Care Bill 7/13/17; or see: a summary from NPR.

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vangie aragon on

Whatever is decided, my concern is that we need NOT penalize individuals that are unable to purchase insurance. It is rather obvious, these people cannot afford it!