Sunday, July 23, 2017

Summary of Vox on Healthcare Bills



a4a Health Group

Summary of Vox Care Article from 7/20/17 as presented at a4a meeting on 7/21/17:

On Tuesday, 7/25 Majority Leader Mitch McConnell has said he will call for a vote on healthcare.  It is not clear to anyone, what exactly they will be voting on.   

Per Vox, there are four separate health care drafts floating around:

The Better Care Reconciliation Act

This is the first Senate Republican attempt at repeal and replace.  It was introduced in mid-June.  It ends Medicaid expansion and significantly scales back the tax credits for middle-income Americans who purchase private coverage. 

What the CBO says:   The BCRA would leave 22 million Americans without health coverage.  It would reduce the deficit by $722 billion because of its significant cuts to health coverage programs.

What’s next:  For this bill, not much.  This version was unable to get enough votes to move it through the Senate.  This is why there are so many other bills now circulating, building on the BRCA in hopes of gaining momentum. 

The Better Care Reconciliation Act 2.0

This is an updated version, which once again would allow insurers to reject people with pre-exiting conditions.  The version includes the Cruz amendment which was meant to win over conservatives who want to deregulate the health insurance marketplace.  BCRA 2.0 also kept certain Obamacare taxes on high income Americans and created a $45 billion fund to fight opioid addiction. 

What the CBO says:  We don’t know!  The Cruz amendment’s language makes it quite difficult for the CBO to analyze.  So no figures right now - although it is similar enough to the original BRCA to expect significant loss of coverage. 

What’s next:  Maybe a failed vote?  BCRA 2.0 does not currently have enough support to move forward.  Several Senators have said they will not support starting debate on this bill.  However, it remains the basis from which they are working on building another health care bill.  Just last night, there was talk about adding $200 billion in Medicaid funding into the mix, so BRCA 2.0 may be well on the path to becoming BRCA 3.0.

Better Care Reconciliation Act 2.0 minus the Cruz amendment

Here is where things start to get very confusing.  This version of the bill does have the Obamacare taxes and opioid funding from BCRA 2.0 but does not have the changes to the individual market (like the return of preexisting conditions).  This version seems to exist solely to be scored by the CBO, which hasn’t yet been able to score the very complex Cruz amendment. 

What the CBO says:  This bill would cause 22 million fewer people to have health coverage, according to a report released on 7/20/17. 

What happens next:  Nada.  This bill pretty much just exits to be scored by the CBO.

Obamacare Repeal Reconciliation Act

Finally, bill with its own name!  The ORRA was introduced on Wednesday.  It repeals Obamacare without a replacement plan and is often referred to as the “repeal and delay” option.  This bill repeals Obamacare’s coverage expansion in 2020, presuming Republicans would come up with a replacement by then. This bill would end the Medicaid expansion as well as the tax credits to purchase coverage in the individual market. 

What the CBO says:  The ORRA would cause 32 million Americans to lose coverage over the next decade.  This number would obviously change, however, if Republicans came up with a replacement plan after passing this repeal bill.

What happens next:  Maybe a vote?  The ORRA seems to be the mix of bills that could be debated on the Senate floor next week – if there is enough support among Republicans to start that debate.  

The Bottom Line

There are plenty of health care draft bills floating around, but none have so far gotten enough support to move forward.  That is why there are so many drafts in the mix right now.  The details of each are different, but the goal is the same:  find one that 50 Republican senators can agree on.

All that being said, it is a crucial time with a potential looming senate vote. We in a4a must KEEP OUR FOOT ON THE GAS PEDAL!  Please continue to repeatedly  write, call, visit and resistbot our senators.  Let them know we want a NO vote on any health care bill, and that it is time to move on and work in a bipartisan manner to repair the Affordable Health Care Act!  Remember, our resistance efforts do make a difference!!!