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Here’s What’s Changed in the Senate GOP’s Revamped Health Care Bill

Here’s What’s Changed in the Senate GOP’s Revamped Health Care Bill

A little something for everyone

Thursday, the Senate Budget Committee released a revamped version of the Better Care Reconciliation Act, or the Senate’s version of the AHCA.

The Senate GOP’s first attempt (in this round of discussions) at the BCRA was met with mehs and groans across the caucus. A small contingent of conservative Senators opposed the bill saying it did little to repeal Obamacare. More moderate Republicans expressed concern over the bill’s promise to eventually cut Medicaid. And others advocated for scrapping the whole bill for a clean Obamacare repeal.

The BCRA is limited to the budget mechanism of reconciliation and we’re told, is a first step to the eventual repeal and replacement of Obamacare, not the end-game.

We’ll have a more detailed analysis after we’ve sifted through the bill (included beneath), but for now, here’s what NBC is reporting:

But changes designed to address concerns of both moderate and conservative Republicans who had different objections to the original bill are also in the new version, including a last-minute addition from Sen. Ted Cruz, R-Texas to allow individuals to purchase cheaper, skimpier health plans. It also keeps some of the Obamacare taxes on the wealthy as an enticement for moderate votes.

That inclusion is a win for conservatives who wanted more choices for consumers. Still, Sen. Mike Lee, R-Utah, who had been working with Cruz on similar ideas, said that he was shut out of the final language and is unsure if this is something he can support at this time.

Changes include more funding to combat the so-called opiod crisis, as well as provisions for cheaper plans and more flexible health savings accounts (HSA):

Here is how the bill changes to appease moderates:

A $45 billion fund to help people with opioid addiction.
An extension of three Affordable Care Act taxes: the 3.8 percent tax on investments on the wealthy; a .9 percent surtax on Medicaid for the wealthy; and a tax on insurance executive’s compensation.
$70 billion to states to help stabilize the cost of health care and implement new reforms, bringing the total in this fund to $182.
Here is how the bill changes to appease conservatives:

Health Savings Accounts, which are accrued from pre-tax dollars, can be used to pay for health insurance premiums.
Catastrophic health plans would be offered and people could be eligible for tax credits to help pay for them.
A health plan with narrow coverage but cheaper premiums would be offered for people in the individual market.

“As before, it aims to stabilize and reform the collapsing insurance markets that have left too many with no options under Obamacare, and it aims to make insurance more affordable and more flexible so it’s something Americans actually want to buy,” said Senate Majority Leader McConnell in a statement.

Full bill text here:

Better Care Reconciliation Act July, 13 2017 by Legal Insurrection on Scribd

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Comments

Fascist-Progressivism Lite is still Fascist-Progressivism.

An extension of three Affordable Care Act taxes: the 3.8 percent tax on investments on the wealthy; a .9 percent surtax on Medicaid for the wealthy; and a tax on insurance executive’s compensation.

How are these taxes considered “equal protection under the law”? Why is there a surtax on “the wealthy” for Medicaid when “the wealthy” don’t even use it? Define “insurance executive”. How is that even fair? For all those who wrote this horrendous bill, clearly not members of Congress, tax THEM for even devising this crap.

It’s really infuriating that this steaming pile of crap is the best the senate republicans can come up with.

More serial failure from the GOPe.

RINOs recoiled in horror when Trump asked for $8 billion to build his wall, but they’re willing to flush $45 billion down the toilet to combat opioid addiction? SMH!

That protest against “cutting Medicaid” is very misleading. They are not fearing cutting benefits to retirees, i.e. those who paid into the system, but cutting out that part of Medicaid that is now funding adult “children”, illegals and other parasites.

It’s all just one big pile of money to these mealy-mouthed hypocrites and liars. They just move money around on paper to have “cuts” to point to or take things off budget…. like those permanent neocon wars.

Kill this thing! Let ObamaCare fail and take this Congress with it for having lied to voters in 2016. Trump should have a field day taking a lot of these RINOs out in the primaries. Imagine a whole new Congress where Republicans actually gain seats despite booting the incumbents out en masse.

The C-Span caption says “minority leader”.
If he keeps it up, it’s gonna happen for real.

It’s the progressive costs and lack of choice, and because of Choice (i.e. denying lives deemed unworthy for Democratic and corporate profits and Mengele experiments/clinical cannibalism), that repulses most people.

Also, the conflation of health care with medical care with insurance products. Affordable may cost less than “free”.

In the words of a now prophetic congresswoman:

Mr. Chairman, we do not have a crisis at Freddie Mac, and in particular at Fannie Mae

Wait a second.

“Health Savings Accounts, which are accrued from pre-tax dollars, can be used to pay for health insurance premiums.”

Yes, good. BUT, are HSA’s permitted to carry money over? I currently have an HSA, and at the end of every year, if I haven’t spent what I put into it, poof. Gone.

Medical Savings Accounts are so anti-Kensian and anti-tax that the current crop of Take-Everything-You-Can-Get politicians refuse to permit them in any realistic way, but MSAs can buffer some of the worst problems of health spending, i.e, the way expenses tend to come in bursts.

    randian in reply to georgfelis. | July 14, 2017 at 1:09 am

    If you’re subject to “use it or lose it”, you don’t have an HSA. You instead have an FSA. Unspent HSA funds are carried over from year to year.

*If* this includes a good version of the Cruz-Lee amendment, I think it could be a very good first step.

Have Cruz or Lee commented yet on the new bill?

Aaaand one more time Republicans fail us.

No repeal. There will be no repeal ever.

I will stop calling them spineless as it now seems clear that they never intended to repeal obamacare. They are walking frauds in a suit. They lied to us over and over, and they will continue to lie to us.

This is what happens when you only have 52 votes, and therefore can only pass what can fit through the budget reconciliation process.

This is the same bind the Democrats were in when Kennedy died and they lost their 60th vote; even with 59, not 52, they couldn’t pass the bill they wanted, because the Republicans all stood firm against it, so they had to limit themselves to budget-related amendments. Had they not had 60 in the first place 0bamacare would not exist today, in any form.

It’s especially what happens when you only have 52 votes and you can’t count on all 52 staying with you, so you can’t even pass budget-related measures that will lose you 3 or more votes.

What would you do in McConnell’s place?

OleDirtyBarrister | July 13, 2017 at 5:18 pm

Some commentators have been vociferous about the problems the Dems have. But in reality, The Stupid Party has the bigger problems. They have been running to repeal O-Care for years, and now with both chambers of Congress and the White House, they can do nothing. Apparently, Trump, the non-politician, getting elected out of a field of 17 is not a clear enough lesson for them.

They are going to fail and lose miserably.

What would you do in McConnell’s place?

I would seriously consider dropping the whole pretense that my failure can be dressed up as some kind of success.

If we can’t have effective competence, we can at least have realistic candor. That shouldn’t be too hard.

Albigensian | July 13, 2017 at 6:35 pm

“A $45 billion fund to help people with opioid addiction”

And what will that $45 billion buy? For although “treatment” seems to be everyone’s solution to opiod addiction, the reality is that all drug treatment, but especially for opiates, has dismal long-term results.

We’re told addiction is a disease (and so it is), and most diseases are treatable, but this disease is also a choice in that one chooses to start using and, ultimately, one must also choose to stop. Nor (for that matter) do most diseases involve activities that those with the disease find intensely pleasurable. And so, absent a strong and durable motivation and commitment to quit, even the most elaborate and costly “treatment” proves futile.

Is it too cynical to assume that $45 billion will do far more for those providing treatment than for those who receive it?

    Mac45 in reply to Albigensian. | July 13, 2017 at 10:07 pm

    You are correct, opioid addiction is not a disease, in the classic sense. Extended use of opiods effects physiological changes in brain structure and body chemistry which requires regular intake of the drugs to allow the body to function. Opioids are so physically addictive that the only reliable treatment is to substitute synthetic opioids for natural opioids. The amounts of these substitute drugs are reduced until a person is able to function, semi-reliably, in society. But long term effectiveness of such treatment is not very good. While it may keep a person from seeking out one type of opiate, the person is still dependent upon another type to deal with changes in brain and body chemistry.

    As long as people keep taking opiates, to the point where the become physically addicted, the problem will never disappear. This proposal is nothing more than a feel good program. You can throw all the money you want at “treatment” and it will do little to eradicate the problem.

This bill will do nothing to significantly affect the healthcare cost problem, which is what drives the healthcare insurance cost problem. But, if passed, the Repubs can point to it and claim victory.

I’d love to report otherwise, but Pence is out flogging this bill.

Der Donald will sign it if it’s passed.

Sorry. I still insist on REPEAL. Period. But that appears to be a vacant hope, even in the face of ALLLLLLLLLL the promises to the contrary, including those by Mr. Establishment.

But I did tell you…