UPDATED: Senate Reverses Again, Will Vote on ACA Repeal Plans
Update 07/26: The Senate decided Tuesday to officially debate and vote on plans to repeal the Patient Protection and Affordable Care Act, also known as the ACA and Obamacare. Despite Majority Leader Mitch McConnell’s statement last week that the Senate would not pursue passage of the Better Care Reconcilation Act, or BCRA, the revised bill is being considered, as well as the “repeal and delay” measure and other past versions of the GOP healthcare bill. Any of these versions of the bill may be changed, using amendments, before a final vote. The plans will be discussed on the floor of the Senate, with members voting on some version of the bill, possibly this week. It is unclear which version of the healthcare plan, if any, has enough votes to pass in the Senate or will be presented after the debate and amendments.
If the Senate passes a plan, the House of Representatives will have to approve that bill, or work with senators on a new bill that both bodies will have to approve, before it is submitted to the president. Continue to call your senators with your concerns about repealing the ACA.
Senate Majority Leader Mitch McConnell announced on July 17 that Republicans are ending efforts to pass the new draft of the Better Care Reconciliation Act. The statement came after two more Republican senators stated they would not support a revised version of the bill that was released July 13.
Mr. McConnell said in a statement that he will now take steps to repeal the Patient Protection and Affordable Care Act, also known as the ACA and Obamacare, without a new law ready to replace it. Once the law is repealed, he plans to delay the effects of that repeal for 2 years while Congress tries to write a new healthcare law.
If the ACA is repealed, you won’t be affected by the change for 2 years, but prices and options in the current insurance market could change as companies prepare for a new law to take effect. The “repeal and delay” strategy was unpopular when it was first suggested earlier this year.
Mr. McConnell had hoped to pass the BCRA quickly, with little debate in public or in Congress, and now hopes to get enough votes to start the repeal and delay strategy this week. If you have concerns about the repeal of the ACA, with or without a new law to replace it, then now is the time to call your senators and let them know.
How Was the Better Care Reconciliation Act Revised?
After a first draft of the BCRA failed to go to vote in the Senate, Republicans last week released a revised version of the bill with a few notable changes in the hopes of gaining more support. Some Republican senators still had concerns with the new draft, however, and Mr. McConnell has since said they will no longer try to pass the revised bill.
Leaders in the House of Representatives made similar statements earlier in the year when the American Health Care Act failed to get enough votes to pass through the House, but then quickly revised it and passed it to the Senate. A similar revival may not be possible for the BCRA, but it is good to know what measures were being considered in the new draft if the bill should come back into consideration.
The Cruz Amendment
The “Cruz amendment,” named for Senator Ted Cruz, who proposed it, would have allowed insurance companies to sell individual plans that do not meet the requirements to be sold under the ACA, as long as they sell one plan that does. This means companies could sell plans that
- don’t cover essential health benefits like hospital stays, prescription medicines and mental health services
- deny people with preexisting conditions coverage, or charge them more and
- limit how much of your health care the plan will pay for
Many experts, along with the insurance companies, said the amendment could create a situation where people who had a disease like breast cancer or need long-term care would have to buy the plans that meet the ACA requirements to have their care covered. The cost of their care would raise prices on these plans and people who are healthy now would likely choose the cheaper plans that offer less coverage. This would leave those people responsible for unexpected medical expenses, but also cause premiums on ACA plans to be even more expensive.
The revised bill set aside more money to keep the insurance markets stable and help with the opioid crisis. This included $45 billion to help treat people with opioid addiction to be spent over the next 10 years. There was also $70 billion added to a fund to keep insurance markets stable. Each state would design their own policies to keep those markets stable and the federal government would support them with money from that fund.
The original draft of the BCRA cut all of the taxes that were passed as part of the ACA. Critics of the BCRA said the bill took funding from programs for the poor, especially Medicaid, and gave that money to the wealthy through these tax cuts. They focused the criticism on a tax on investment income and a Medicare surcharge, two taxes that were directed at people making more than $200,000 per year. The revised BCRA cut all of the ACA taxes but left those two in place.
Using Health Savings Accounts to Pay Insurance Premiums
Health Savings Accounts allow people to set aside money, before taxes are taken out, to spend on health-related expenses like co-pays, co-insurance and medical bills before you reach your deductible. The revised BCRA would have given some tax relief by allowing people to use money from their HSA to pay for insurance premiums, which is not allowed at the moment.
Most of the bill was the same as it was presented in June. It still includes
- drastic cuts to how much the federal government will give to Medicaid
- a 1 year ban on Medicaid being used at Planned Parenthood clinics
- a waiting period for anyone who goes for more than 2 months without coverage
The BCRA may no longer be up for consideration, but future healthcare policy is still being decided. Call your senators to have your voice heard.