Benefits and Compensation

Senate Issues Revised Version of ACA Repeal-and-Replace Bill

On July 13, the Senate released a revised version of its proposed Affordable Care Act (ACA) repeal/replace bill, known as the Better Care Reconciliation Act of 2017. As of July 13, the Senate had not yet voted on the original version.


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The revised version of the bill includes a “consumer freedom” amendment to the ACA that would allow consumers to purchase lower-premium catastrophic plans with stripped-down coverage; the current law requires all plans to provide certain minimum essential health benefits. Detractors of the ACA believe these requirements drive up the cost of health care and force healthy people to enroll in plans that may provide more coverage than they want.

The revised bill would allow consumers to use health savings accounts (HSAs) to pay for their premiums. It also provides nearly $45 billion from 2018 through 2026 to help states battle opioid addiction.

While deep cuts to Medicaid were a sticking point for many senators with the initial version of the bill, the revised version maintains these cuts. It does, however, provide new flexibility relating to Medicaid spending caps in the event of a public health emergency.

Unlike the previous version of the bill, the new version maintains two existing ACA taxes on those earning over $200,000 per year (or $250,000 per year for married couples): a 3.8% tax on investment income and a .9% payroll tax.

A Congressional Budget Office score on the revised version of the bill has not yet been released, and it is unclear whether the new changes will garner the legislation sufficient votes to pass in the Senate.

JenJennifer Carsen, JD,is a Senior Legal Editor for BLR’s human resources and employment law publications, focusing on benefits compliance. In the past, she served as the managing editor of California Employer Resources (CER), BLR’s California-specific division, overseeing the content of CER’s print and online publications and coordinating live events and webinars for both BLR and CER.

Before joining CER in 2005, Ms. Carsen was a Legal Editor at CCH, Inc. and practiced in the Labor & Employment Department at Sidley & Austin, LLP in Chicago. She received her law degree from the New York University School of Law and her B.A. from Williams College. She is a member of the New Hampshire Bar Association.

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