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-and-replace bill, known as the Better Care Reconciliation Act of 2017. The Senate has yet to vote on the original version.

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 the requirements drive up the cost of health care and force healthy people to enroll in plans that provide more coverage than they want.

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

Deep cuts to Medicaid were a sticking point for many senators with the initial version of the bill, and the revised version maintains the cuts. It does, however, provide new flexibility related 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 individuals earning more than $200,000 per year ($250,000 per year for married couples): a 3.8 percent tax on investment income and a .9 percent payroll tax.

The Congressional Budget Office (CBO) has not released a score on the revised version of the bill, and it is unclear whether the changes will garner sufficient votes for the legislation to pass the Senate.