Update: On June 27, Senate Majority Leader Mitch McConnell announced that a vote on the Senate bill will be delayed until after the July 4th recess.
Following the May passage in the House of the American Health Care Act (AHCA), the Senate has now released the text of its own draft ACA reform bill.
Dubbed the “Better Care Reconciliation Act of 2017,” the 142-page Senate proposal is substantively quite similar to the AHCA—including its elimination of the employer and individual mandates—with a few distinctions. Among other provisions, the Senate proposal:
- Reduces the income level required to qualify for premium tax credits. Currently, under the ACA, those earning 400% of the federal poverty level are eligible; the Senate proposal drops this to 350%. The tax credits would also cover leaner plans than they do now.
- Rolls back the existing Medicaid expansion more slowly, but ultimately more drastically, than does the AHCA.
- Allows states to opt out of most of the ACA’s coverage requirements, including those relating to maternity care, emergency services, and mental health; the AHCA also allows states to do this.
- Prohibits insurers from denying coverage or increasing premiums because of preexisting conditions. This is the current state of affairs under the ACA; the AHCA introduces an exception for those with coverage gaps.
- Provides for a one-year defunding of Medicaid reimbursements to Planned Parenthood, as does the AHCA.
- Maintains, as does the AHCA, the popular ACA provision that dependents may remain on their parents’ coverage through age 26.
Senate majority leader Mitch McConnell hopes to hold a vote on the proposed legislation before the Senate breaks for its July 4 recess.
It is unclear—even with modifications, which are likely—whether the bill will receive the necessary support to pass. The bill needs a minimum of 50 of the Senate’s 52 Republican members on board; no Democrats are expected to vote in favor of it. Additionally, the Congressional Budget Office still needs to weigh in on the financial implications of the bill.