Collapse of Senate Health Care Bill: Better Care Reconciliation Act: What Now?

Author Details

Cary Sanders

Senior Policy Director
csanders@cpehn.org

Organization: California Pan-Ethnic Health Network

Go to California Pan-Ethnic Health Network

The failure of Trumpcare for the second time in a row, shows the GOP’s health care overhaul is deeply flawed and cannot be fixed. The Senate GOP plan, the Better Care Reconciliation Act (BCRA), would have caused 4 million Californians, a majority from communities of color to lose their health care coverage. Additionally, the bill would have destabilized the insurance market and cost the state thousands of good paying jobs.

Despite this, California’s Republican Congressional delegation voted for an earlier version of this mean-spirited bill drafted in a closed door, partisan process with no hearings and virtually no input from the people most affected. 

Unfortunately President Trump and Senate leader Mitch McConnell are pushing to repeal the Affordable Care Act now and replace it later resulting in as many as 32 million Americans losing coverage. This plan too would be devastating for California and create havoc for the whole health care system.

Rather than repeating the same failed, closed door, partisan process, we call on California Republican Congressional representatives to set Medicaid aside, cease efforts to repeal and replace the ACA and work with Democratic leaders to identify a plan that actually improves the current health care system by reducing costs, ensuring long-term stability to the insurance market and creating greater access to quality care for all Californians including immigrant communities.

It’s time to make the Affordable Care Act work for everyone – with better care, for more people, at a lower price.

What happened?

On Monday July 17th, two additional Senate Republicans joined Republican Senators Snow (R-Maine) and Paul (R-Kentucky) in declaring they cannot support the Senate version of the GOP healthcare bill – specifically on a procedural motion to take up the bill thereby dashing hopes for a vote and blocking the current legislation. Several Senators have called for a “fresh start” with Senator McCain going so far as to say, “Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.”

What’s being proposed now?

Despite calls by prominent Republicans to scrap the bill and reach across the aisle for solutions, President Trump and Senate Majority Leader Mitch McConnell are threatening to move ahead with a bill that would repeal now and replace later.  Although several Senators have come out against this plan, we are hearing a vote on the “Motion to Proceed” may be scheduled for next week. We agree with Democratic Senator Chuck Schumer, Republican Senator McCain, and the bipartisan group of eleven Governors that it’s time for a fresh start, to work across the aisle, and find real solutions to ensure more people have access to quality, affordable health care coverage.

What’s in the Repeal Now Replace Later bill?

Assuming a similar timeline to the 2015 version, the repeal only bill would:

  • Eliminate coverage for 18 million people in 2018, 27 million by the early 2020s, and 32 million by 2026.
  • Completely end expansion as of January 1, 2020. There would be no phase out, and no statutory option for states to keep their expansions even if they could afford to do so at regular match.
  • Completely eliminate the ACA’s tax credits and cost sharing subsidies – with no replacement – as of January 1, 2020.
  • Immediately repeal the ACA’s high-income and corporate taxes, cutting taxes for households with incomes over $1 million by over $50,000 per year.
  • Immediately repeal the ACA’s individual and employer mandates.

What happens if this latest Senate effort fails? Unfortunately if this latest attempt to pass a repeal now, replace later bill fails, the fight is far from over. President Trump tweeted today that he’d rather “let Obamacare fail” than work with Democrats to improve the ACA. Research shows the ACA is actually working despite the President’s efforts to sabotage the law. Moving forward, the President can continue to threaten health care coverage for millions and destabilize the insurance markets by using his regulatory authority to undo critical ACA consumer protections, approve massive federal budget cuts and eliminate cost-sharing subsidies that help people pay for their care. All of these actions would be devastating for California.

California’s Republican Congressional delegation has a choice: go along with the President’s cynical attempts to destroy Obamacare or as Senator McCain said hold open hearings where input from members of both parties and the public, including our nation’s governors is heard and considered.

Your efforts are working…It’s up to us to make sure policymakers continue to hear from ordinary people who will be impacted by the loss of health care coverage. California, the most diverse state in the country, expanded health choices under the Affordable Care Act to more people than any other state, and reaped the benefits – stronger, healthier communities that make the Golden State the sixth-largest economy in the world. We have glimpsed a brighter future for everyone, and we refuse to roll back progress.