Senate’s BCRA Includes Major Changes to Medicaid and the ACA

Last week, Senate Republican leadership released the Better Care Reconciliation Act of 2017 (BCRA), which would repeal and replace the Affordable Care Act (ACA). While Senate Republicans do not yet have the requisite votes to pass the legislation, and did not start the debate this week as planned, the bill is still very much alive. Senate Republicans continue to consider changes to the BCRA to get the votes needed for passage.

This advisory analyzes the provisions of the BCRA, including the amendments to the BCRA released Monday. Among other things, the BCRA would: make major changes to the federal subsidies provided to purchase individual market health plans; roll back several of the ACA’s health insurance market reforms; expand State flexibility under Section 1332 waivers; phase-out increased federal funding for the Medicaid expansion; and impose a per capita cap on state Medicaid expenditures.