The formation of the Better Care Reconciliation Act (BCRA) happened in secret and intentionally lacked transparency.
The Senate Healthcare Bill -- known as the Better Care Reconciliation Act (BCRA) -- was formed in secret and intentionally lacked transparency. Senate Republicans have done a masterful job of ensuring that any media coverage only skims the surface, and for good reason. The name of this legislation is ironic. It would not provide better care, nor does it reconcile the shortcomings of the Affordable Care Act (ACA). It is a catastrophic piece of legislation that would rob health coverage from those who need it most in exchange for $33 billion in tax cuts to the 400 highest-income households in the country. No one outside of Hill staffers saw the legislation until late last week, when the BCRA was finally released to the public after weeks of pressure.
The most significant of BCRA’s blows is its draconian cuts to Medicaid. Obamacare provided federal funding to states to expand Medicaid programs, but Virginia’s General Assembly refused it, leaving over 400,000 people in the coverage gap. If the bill becomes law, it would leave those same people without coverage and take another 300,000 Virginians off of Medicaid. 14,100 of those would be veterans who the current administration promised to support and protect.
The BCRA would not only strip millions of families of affordable health care, it would injure our state’s economy. Estimates show the Senate’s repeal plan will cost Virginia’s taxpayers at least $1.4 billion over the next seven years. In the words of Governor McAuliffe, it will force the state to “choose between cutting benefits for families who need them, slashing investments in other core services like education and transportation, or raising taxes”. Even historically conservative chairman of Virginia’s House Appropriations committee, Delegate Chris Jones, has come out against BCRA because it will be a budgetary disaster for the state.
The Senate’s legislation also allows states to take “essential health benefits” (EHB) waivers, eliminating minimum coverage requirements outlined in the Affordable Care Act. If Virginia’s next governor chooses to accept the EHB waiver, comprehensive plans would no longer be required; meaning no coverage for maternity care, prescription drugs, and mental health and substance use disorder services. Virginia’s jails and prisons already treat more people with serious mental illness than our state mental hospitals. If Virginia took such a waiver, we would face an unprecedented overload of our already broken criminal justice system.
The Congressional Budget Office (CBO) stated in their analysis of BCRA that most low-income Americans will likely be unable to afford any type of health coverage. Older individuals will also have difficulty paying. In Virginia, the annual premium for 60 to 64-year-olds is expected to be $13,790 in 2026. If ACA is still in place, it will only be $1,700.
Outside of the budgetary crises BCRA will cause and the number of people that will lose coverage, the most appalling statistic is the number of people that will die solely because they cannot receive health care. The Center for American Progress projects over 219,000 people will die, due to a lack of health insurance coverage, by the year 2026. These are additional deaths that are not expected if ACA remains the law of the land.
If ACA is repealed, it must be replaced with something that will protect our health care. Conservatives on the Hill are driven by their disdain for the ACA and continue to come up with bad alternatives. They will be doing everything in their power to make this bill pass. Fortunately, in Virginia, Senators Mark Warner and Tim Kaine have said they will not vote for this bill. However, there are 15 other states with senators who are likely to vote against the bill, but need to hear from their constituents. Additionally, Virginia’s members of the House of Representatives need to hear from their constituents. The coming days will make or break the Senate repeal bill. The Senate must kill this bill or we will be forced to live with the devastating consequences.
Josie Mace is the Policy Associate at New Virginia Majority, specializing in health care policy.