June 2017

Early this week, the Senate Republican leadership announced that they would postpone floor votes on Affordable Care Act (ACA) repeal and replace legislation, called the Better Care Reconciliation Act (BCRA) until after the July 4 recess week, after numerous Republican senators expressed multiple concerns with the bill, including proposed Medicaid cuts and inadequate funding for the opioid crisis. Efforts to hold a procedural vote that would have enabled quicker movement to floor votes on the bill during the week of July 10 also failed.

The Congressional Budget Office (CBO) has estimated that the BCRA would cause 22 million Americans to lose health insurance coverage within 10 years, with 15 million losing coverage within one year of the bill's enactment. The CBO also estimated that the bill's changes to Medicaid's funding structure along with ending the ACA's Medicaid expansion funding, would reduce the program's funding by 35 percent by 2026. The current draft of the BCRA would also do the following:

• Reduce federal subsidies for low-income Americans to purchase private health insurance
• Allow states to waive essential health benefits and permit annual and lifetime coverage caps, which will result in reduced coverage and higher costs in some states
• Allow insurers to charge older Americans up to five times more than younger people for insurance

The Senate leadership will be making changes to the BCRA and negotiating to secure Republican votes over the next week, and perhaps beyond, so we do expect some aspects of the bill to change. It is likely that there will be changes to the bill's Medicaid provisions and other areas and additional funding added for the opioid crisis. At this point, the Senate leadership aims to begin floor votes on the bill as early as July 11.

The ATS remains deeply concerned about the BCRA and sent a letter to the full Senate this week urging senators to vote "no" on the legislation. We urge members to continue contacting their two senators to urge them to vote "no" on the Better Care Reconciliation Act. Some senators will be holding Town Hall Meetings during the week of July 4. We encourage members to attend these events and urge your senator to vote against the Better Care Reconciliation Act. Click here to find congressional town hall meetings in your state.