Monday, July 17, 2017

Members Urged to Contact Senators While McCain Recuperates

The Senate Republican health care reform bill, titled the Better Care Reconciliation Act (BCRA), appears to be on hold indefinitely until Sen. John McCain (R-Ariz.) returns to the Senate from surgery for a blood clot.

At press time, it was uncertain whether the bill would garner the necessary 50 votes for passage, even if McCain were available. In the meantime, however, APA continues to urge members to contact their Senators to voice opposition to the bill and use this delay to continue to voice their concerns. 

The BCRA, revised after an earlier version of the bill failed to make it to the Senate floor in June, retains some of the most problematic aspects of the original bill. These include deep cuts to Medicaid and the ability to waive the “essential health benefits” that must be covered in plans under the Affordable Care Act (ACA), including benefits for mental health and substance use disorders treatment.

Based on analysis by APA staff, the bill proposes to do the following:
  • Fundamentally alters the payment structure of the Medicaid program. Beginning in FY 2020, state Medicaid programs will be funded on a fixed per-beneficiary basis (that is, a per capita cap). 
  • Phases out Medicaid expansion made available to states under the ACA. States will no longer be able to expand eligibility for their Medicaid programs on January 1, 2020.
  • Establishes an optional block grant program called the Medicaid Flexibility Program.
  • Adds administrative costs and burdens to Medicaid programs. The BCRA requires states to reassess enrollees’ Medicaid eligibility once every six months. It would also give states the option of requiring nondisabled, nonelderly, and nonpregnant individuals to satisfy work requirements as a condition for eligibility.
Also under consideration is a controversial amendment to the bill proposed by Sen. Ted Cruz (R-Tex). The amendment would allow insurers to offer plans that do not comply with the ACA’s mandatory coverage provisions, including the requirement that plans cover certain “essential health benefits,” the prohibition against insurers increasing premiums for individuals with pre-existing conditions, and the requirement that plans offer a free annual preventative care visit to enrollees.

APA Department of Government Relations staff have prepared a detailed analysis of the bill as well as a side-by-comparison of all of the health reform proposals in play: the existing Affordable Care Act, the House-passed American Health Care Act, the initial version of BCRA from June, and the revised BCRA now pending in the Senate.

To make contacting your senator as easy as possible and voice your opinion, APA has established a special portal on the APA website that provides messaging and contact information specifically for your senators.

(Image: YinYang/


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