ARxC Update for Senate’s Better Care Reconciliation Act (BCRA)

Article Type: 

July 17, 2017

This latest version of the Senate’s Health care Bill does not fix any problems. The Better Care Reconciliation Act (BCRA), the draft bill released by the Senate on June 22, threatens public health in two critical ways. (

First, BCRA phases out Medicaid Expansion, which means that states would have to spend much more out of their public health budgets to meet the needs of individuals who lose Medicaid coverage. Second, BCRA eliminates funding for the Prevention and Public Health Fund, (PPHF) which is the fund that supports critical public health projects such as prevention, disease management and treatment programs. BCRA strips critical safeguards, weakens the waiver application review process and allows states to eliminate key consumer protections by simply showing that the proposed plan does not increase the federal deficit. BCRA also lets states avoid the requirement that plans in the Marketplace provide coverage for a set of essential health benefits (EHBs), including maternity care, prescription drugs, and mental health (MH) and substance use disorder (SUD) treatment. Waiving the EHB requirement would lead to skimpier Marketplace plans that do not provide coverage for basic health care services. Individuals who need access to these services will either be unable to get covered or will find comprehensive coverage unaffordable.

The Congressional Budget Office Score (CBO) will also be delayed. This score is important to provide cost estimates that analyze the likely effects of this bill on the federal budget. 

As advocates we must ask Senators to reject this bill and move immediately to address market stability.

The latest version of BCRA still:

            -Ends Medicaid expansion

            -Drastically cuts and caps the entire Medicaid program

            -Raises premiums and deductibles; and

            -Abandons all consumer protections (for EHB, pre-existing conditions, etc.)

The cuts in this bill hurt all Americans and especially the most economically burdened and those who are most ill. The bill benefits the wealthy, drug companies, insurers, corporations in $400 billion in tax cuts.

Senate Republicans are trying to push this bill through next week. It is likely other amendments and changes will be made right before the vote. These amendments like the Sen. Cruz and Sen. Graham proposals will still create serious access and affordability problems for anyone with a pre-existing health condition, chronic disease or disability.



1.    Call your Senators at 866.426.2631

2.   Tell your Senators to “reject this bill which causes large coverage losses, ends Medicaid expansion, caps and cuts the Medicaid program and eliminates critical protections for people with health conditions.” “As your constituents we ask you to pursue a bipartisan approach that leaves Medicaid alone, secures affordable access to coverage for those with health conditions and stabilizes the marketplace while improving affordability”.

3.   Please use #ProtectOurCare; #KillTheBill on all social media channels and with every posting.