Republican senators unveiled an updated version of their healthcare bill on Thursday, which includes a controversial amendment that could effectively lead to the deregulation of the health insurance market.
The Better Care Reconciliation Act (BCRA) was first introduced last month, but it failed to accumulate enough support to be put to a vote. The bill was similar to the House of Representatives' approved American Health Care Act (AHCA), but it included some key changes that did very little to appease both moderates and hardline conservatives.
With all Democrats unanimously standing against the plan to repeal and replace Obamacare, Majority Leader Mitch McConnell can't lose more than two Republican votes or the bill won't pass. Sen. Susan Collins and Sen. Rand Paul have said they won't support the bill (for very different reasons), so the amendments introduced today are McConnell's efforts to appeal conservatives who opposed the original bill because it didn't do enough to repeal key parts of Obamacare, such as Sen. Ted Cruz.
We'll have to wait for official analysis to see what the impact of the revised bill may be. But, a study by the nonpartisan Congressional Budget Office found that the original version of the BCRA would leave an additional 22 million people without health insurance by 2026 if it becomes law. The revisions McConnell made are unlikely to significantly decrease that figure.
It's still unclear if the revised BCRA will garner enough support in the Senate. Ahead, we break down everything you need to know about the new version.
What is different?
The Consumer Freedom Amendment: This is perhaps the biggest change to the BCRA. The updated legislation would eliminate Obamacare provisions demanding insurers to meet some minimum requirements. The Consumer Freedom Amendment, introduced by Sens. Cruz and Mike Lee, would allow insurers to offer slimmed-down coverage and fewer benefits for cheaper if they also sell at least one plan that complies with the Obamacare regulations.
Under the slimmed-down health plans, insurers could opt out of offering coverage for preventive healthcare as required by Obamacare, including opting out of covering birth control without a copay.
Opioid epidemic: The bill will allocate an additional $45 billion for substance abuse treatment and recovery.
What remains the same?
Pre-existing conditions: Insurers are prohibited from charging higher fees to people with pre-existing conditions.
Medicaid: The bill would roll back the Medicaid expansion over a three-year period, starting in 2021. The cuts will be deeper than in the House healthcare bill, because the BCRA will determine the amount of money a state would get based on standard inflation instead of medical inflation.