Monday was an eventful day for the Senate health care bill.
First, Senate leaders released a slightly revised version of the “Better Care Reconciliation Act of 2017” Monday morning as Senate Majority Leader Mitch McConnell attempts to win over enough holdout Republican senators to pass it.
The biggest change is the inclusion of a new provision to encourage Americans to maintain continuous health care coverage in place of Obamacare’s individual mandate. The new provision, which would take effect in 2019, would impose a 6-month waiting period before new insurance can go into effect for anyone who had a break in coverage lasting 63 days or longer in the prior year.
Prior to the revision, at least six Republican senators had signaled opposition, and many more are still demanding a variety of changes.
Republicans can only afford two defections and still pass the Obamacare repeal legislation, but senators only saw the draft bill for the first time last Thursday.
Then late Monday afternoon, the non-partisan Congressional Budget Office (CBO) released its analysis of the Senate health care bill released last Thursday, projecting that the new bill, if passed, would result in 22 million more uninsured Americans over the next decade compared to Obamacare.
CBO and the Joint Committee on Taxation (JCT) estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade relative to current law. That amount is $202 billion more than the estimated net savings for the version of H.R. 1628 (AHCA) that was passed by the House of Representatives.
The largest savings would come from reductions in outlays for Medicaid—spending on the program would decline in 2026 by 26% in comparison with what CBO projects under current law—and from changes to Obamacare subsidies for nongroup health insurance. Those savings would be partially offset by the effects of other changes to Obamacare provisions dealing with insurance coverage: additional spending designed to reduce premiums and a reduction in revenues from repealing penalties on employers who do not offer insurance and on people who do not purchase insurance.
The largest increases in deficits would come from repealing or modifying tax provisions in Obamacare that are not directly related to health insurance coverage, including repealing a surtax on net investment income and repealing annual fees imposed on health insurers.
McConnell has said he wants a vote on the bill this week, before senators head home for the July Fourth recess. With Senate Democrats united in opposition, Republicans can afford to lose only two votes on their side and still pass the bill. With both moderates and conservatives on the record expressing deep concern about the bill, it faces an uphill road to passage.
- Read the CBO analysis here
- More coverage of Better Care Reconciliation Act of 2017:
- Related discussion threads: