Or better known as, the Republican Senate’s answer to repealing and replacing the Affordable Care Act (aka Obamacare).
Last Thursday, the much talked about, clandestine healthcare bill that Senate Republicans were working on had been finally revealed! It was called the Better Care Reconciliation Act (or the BCRA) and as you expected, it’s become pretty controversial.
Protesters chanting "no cuts to Medicaid" outside McConnell's office. Capitol Police blocked the hallway & protesters are being removed pic.twitter.com/RhVwJPwYtK
— Andrew Desiderio (@desiderioDC) June 22, 2017
So what’s in the BCRA? Well, let’s take a look.
Point 1: The Better Care Reconciliation Act (or BCRA) is the Senate Republican’s vision of the repealing and replacing of the Affordable Care Act (aka Obamacare). The replacement of the ACA is something Congressional Republicans have been promising for a long time now. For both the GOP and the Trump administration, the repeal of the ACA is something that has been promised to their conservative base back in 2016.
Point 2: Similar to the House GOP’s American Health Care Act (AHCA), the main focus of the BCRA looks to cut the monetary burden of healthcare on the federal government. The Congressional Budget Office (CBO) estimates that direct spending by the federal government would reduce by $1,022 billion over the next ten years.
Point 3: Yet for the BCRA’s cuts that save billions for the federal government, all of it comes at a severe cost. In this case, that cost is 22 million individuals losing healthcare coverage (!!!) according to the CBO estimates. By 2026, that uninsured number balloons to 49 million under the BCRA. As you may have guessed, this legislation has led to its fair share of protests.
Point 4: A big part of the BCRA’s cuts come from phasing out the ACA’s Medicaid expansion in 2021. That would also include limiting federal funding to states that provide healthcare through Medicaid assistance. Considering under the ACA, Medicaid covers more Americans than the private marketplaces, this cut would be significant to millions of Americans.
Point 5: The BCRA would also allow states to opt out of the current ACA marketplaces and essential health benefits for individuals. The replacement would be a new waiver system that allows states to overhaul their insurance marketplaces, with the only exception being that their cost never adds to the deficit. In laymen’s terms, the BCRA wants to essentially dismantle the state marketplaces that the ACA created.
Point 6: Multiple analysis of the BCRA, including one by the Kaiser Family Foundation, have predicted that premiums for various insurance plans would raise significantly under the Senate Republicans healthcare plan. The healthcare subsidies, that many currently get with the ACA, would basically be much smaller for everyone across the board. In short, more people will pay more and get less coverage in their insurance under the BCRA.
Point 7: One of the less popular aspects of the current healthcare law is the individual mandate, which makes individuals get healthcare coverage or face a hefty fine. Under the BCRA, the individual mandate would be replaced with a 6-month waiting period for those wanting individual coverage. Essentially, instead of a fine under the BCRA, those individuals would have to wait 6-months before they can buy health insurance. The hope of this provision is to keep healthy individuals in the healthcare pool, which theoretically would decrease the cost of health insurance.
Point 8: What many have forgotten about the BCRA is that it acts as a change in the tax code as well. Because of this, the BCRA provides significant tax cuts to insurance companies (the CBO estimates around $145 billion in tax cuts by 2026) and also provides major tax cuts to the wealthy (the CBO also estimates that $172 billion in tax cuts on capital gains by 2026). For many against the BCRA – particularly Senate Democrats – these tax cuts on the wealthy have been a major sticking point.
Point 9: Basically, BCRA benefits two groups specifically: (1) those that are healthy and (2) those in higher income brackets. Those that are healthy theoretically end up paying less for health insurance due to the significant cuts in Medicaid and sicker individuals paying more (or being outright denied) for health insurance. As for those in higher income brackets, they should be getting a generous tax cut under the BCRA. However, the BCRA greatly disadvantages the elderly and sick because under this healthcare law, they would end up paying more for health insurance, but in turn get less coverage.
Point 10: As of this writing, the chances of the BCRA passing in the Senate is very much up in the air. Even with Senate Republicans using budget reconciliation rules to get the BCRA to only pass with 50 votes, Senate Majority Leader Mitch McConnell is still having a rough time getting Republican support behind the bill. Originally, McConnell wanted to put the BCRA to a vote in the Senate before the July 4th recess, but reports now show that he’ll need more time to gin up Republican support for their healthcare bill. For all intents and purposes, the BCRA may be the Republicans’ last real chance at repealing and replacing the ACA.
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