BCRA 2.0: What Might Be in the New Senate Healthcare Bill

Cruz, Paul Drew AngererGetty
Drew Angerer/Getty

Senate Majority Leader Mitch McConnell hopes to tweak the Better Care Reconciliation Act (BCRA) to shore up the votes to pass it through the Senate before the August recess.

McConnell might include $45 billion in funding to help combat the opioid crisis, which is up from the $2 billion included in the original BCRA. Increased opioid funding would help shore up support from moderate Sens. Shelley Moore Capito (R-WV) and Rob Portman (R-OH).

Senate leadership will likely include changes to Health Savings Accounts (HSAs), which would allow for Americans to use HSAs to pay for premiums. A Senate aide said that the change to HSAs could cost around $60 billion in lost revenue, as the federal government does not tax HSAs.

Sen. Susan Collins (R-ME), one of the senators who came out against the BCRA, wants to scrap the BCRA’s repeal of the 3.8 percent investment tax on wealthy people. Retaining the 3.8 investment tax on wealthy Americans would allow for more funding to give more Americans health insurance coverage and eliminate the narrative that the Senate healthcare bill amounts to a tax cut for the rich.

Sen. Bob Corker (R-TN) believes that the Senate leadership will more than likely keep the tax on wealthy Americans’ investments. Corker said, “We are going to figure out a way, I believe, before Friday comes to greatly enhance the ability of lower-income citizens to buy insurance on the exchange, and at the same time, my sense is that the 3.8 percent is going to go away. It’s not an acceptable proposition to have a bill that increases the burden on lower-income citizens and lessens the burden on wealthy citizens.”

Sen. Ted Cruz (R-TX) wants to allow health insurers to sell plans that do not comply with all of the Obamacare insurance regulations. Cruz argues that selling plans that do not adhere to all of the Obamacare insurance regulations would allow Americans to choose more flexible and affordable healthcare plans.

Sen. Cruz previously wanted to include the House-passed bill’s state waivers to allow for states to sell more affordable health insurance plans. “If we’re going to lower premiums, we have to give consumers flexibility to be able to purchase more affordable plans,” the Texas senator explained. “We have to give states flexibility to innovate to provide creative solutions so that those in need receive better care.”

Despite McConnell’s potential changes to the bill, Sen. Rand Paul (R-KY) believes that the Senate remains at an impasse. Paul said, “I still sense that we’re at impasse. There’s still quite a bit of disagreement.”

The Kentucky Senator suggested that the Senate could potentially split the Senate healthcare bill into two, one bill to repeal Obamacare, which would pass with conservative support, and another spending bill which would entice Democrats to support the measure.

Paul explained, “So what I’ve come up with, and I talked to the president yesterday about this, is what about dividing the bill in two? Do the repeal, which no Democrat will vote for. Repeal the taxes, repeal the regulations, and do a fix to Medicaid that helps to pay for everything. No Democrats will vote for anything good like that. But Democrats will always vote for spending. So the big government Republicans that want more spending, take the spending and put it in the bill that Democrats will vote for.”


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