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Senate Releases Revised Health Care Bill: Better Care Reconciliation Act

As you know, the American Health Care Act (AHCA) was introduced March 6, 2017 as the bill that would repeal and replace the Affordable Care Act (ACA). The U.S. House of Representatives voted on and passed this bill on May 4, 2017. Subsequently, the Congressional Budget Office (CBO) released their review of AHCA, prompting some Senate legislators to voice concern over the bill in its current state. Revisions were expected and those revisions are now drafted.


What Happened Last Week: Better Care Reconciliation Act (BCRA)

The Senate’s revised draft of the AHCA bill, titled Better Care Reconciliation Act (BCRA), was draftedby Senate Majority Leader Mitch McConnell and released on Thursday, June 22, 2017. Some BCRA highlights include:

  • The employer mandate (employers with 50+ employees must provide affordable and ‘minimum value’ insurance) penalty would be reduced to zero
  • Cadillac tax would be delayed until 2026
  • Medicaid expansion (introduced by ACA) would be phased out over 3 years, starting in 2021
  • Requirements would be more lax for states to request waivers to offer health care plans that don’t include the 10 essential benefits (such as mental health, maternity care and emergency services)
  • ACA reporting requirements for large employers would still remain in effect (although it is in question whether it will be enforced or not)
  • Health Savings Accounts (HSA) would expand in the following ways:
    • Contributions would increase to $6,550 for single and $13,100 for family
    • Could be used to pay for over-the-counter medications (prohibited under ACA)
    • Tax penalty would decrease to 10% if individuals used HSA to pay for unqualified medical expenses
    • Both spouses could make catch-up contributions to one HSA effective 2018


Here’s What’s Expected to Happen this Week: CBO to Estimate Cost of BCRA

The CBO should be releasing their estimate of the BCRA this week, perhaps as early as today.

The Senate is fast-tracking this bill so a vote could take place as early as next week. They want the vote to be done prior to their July 4th recess or support for the legislation could be lost. Currently, it doesn’t look like there is enough Republican support for the bill to pass.


Next Steps: What to Watch For

If the BCRA is passed by Senate, it will go back to the House. Three things could happen: House can pass the bill as-is, pass another version of the bill and send to the Senate for a vote, or have key leadership in both chambers have private negotiations to find a middle ground that will achieve agreement on both sides. Lawmakers hope to pass the final legislation for this bill by the end of July.

NIS will continue to monitor the situation and keep you informed. Contact your NIS Consultant if you have any questions.

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Erin Woulfe
Erin Woulfe
Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization or just providing tips and how-to’s to help them make their job easier.”

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