With Support for Republican Health Care Bill Flagging, Repeal and Delay is Back on the Table

Prior to adjourning for the July 4th recess, the Senate put out a slightly tweaked version of the Better Care Reconciliation Act (BCRA).

The biggest change from the prior version was to add a six-month prohibition from obtaining coverage for individuals who have a break in coverage for more than 63 days. This was intended to encourage individuals to maintain continuous coverage and discourage people from attempting to forgo insurance coverage unless they become ill.

The new draft came out ahead of a revised Congressional Budget Office (CBO) report, which estimated that the BCRA would cut Medicaid by $772 billion and result in approximately 22 million people becoming uninsured. These numbers are lower than the CBO estimates on the House-passed health care bill, the American Health Care Act (AHCA), but still deeply troubling for people with disabilities that rely on Medicaid benefits. Democrats pushed CBO to perform a 20-year analysis, instead of its usual 10-year estimate, saying that the BCRA hid many of its long-term costs by pushing them to after the 10-year mark. As reported by Modern Healthcare, the 20-year analysis shows that Medicaid spending would fall by thirty-five percent over two decades.

Republican leadership is using the July 4th recess, which runs from June 30 to July 11, to attempt to negotiate concessions that will bring Republican Senators that have voiced opposition to the bill on board. One such concession was an increase of $45 billion to address the opioid crisis, aimed particularly at Rob Portman (R-OH) and Shelley Moore Capito (R-WV). That amount falls well short of what the Senators asked for, so it is uncertain whether it will be enough to move them to support the bill. Meanwhile, the Democratic Staff of the House Committee on Oversight and Government Reform released a series of reports which show the impact of the BCRA to individual states, highlighting the impact for children with significant disabilities and special health care needs.

Republican Senators are facing pushback from constituents in their home states over the BCRA, leading the White House and some Senators to switch gears and start talking about “repeal and delay” of the Affordable Care Act (ACA), instead of the partial repeal and replacement of the BCRA. Senator Ben Sasse (R-NE) said that if lawmakers are unable to come to an agreement on passing the BCRA, they should vote for a full repeal, with a one year delay to give them time to work on a replacement. President Trump also voiced support for the “repeal and delay” approach in an interview over the weekend. Senate Majority Leader Mitch McConnell (R-KY), however, has rejected that idea, saying that the Senate needs to “stick with that path” of moving forward with the BCRA. He added, “It’s not easy making America great again, is it.”

ANCOR put out an advocacy toolkit to assist members in making calls, conducting in-state constituent visits with Senators and staff, and attending town halls and other events. That toolkit is attached below. We encourage all members to use this week to ramp up advocacy efforts, as moving the BCRA to a vote will be the top priority when the Senate comes back into session the second week of July.