ACA-AHCA Side-by-Side Updated

On June 22, Senate Republicans released their version of the American Health Care Act (AHCA) passed in the House in May.  The Senate bill entitled the “Better Care Reconciliation Act” was released after weeks of discussions held behind closed doors.  It closely follows the House bill taking steps to repeal and replace the Affordable Care Act (ACA) and would make significant changes to the Medicaid program.  The legislation has more moderate provisions in some respects and less moderate ones in others.  The APA Called on Senators to Reject this Deeply Flawed Health Care Proposal.  Both of Maryland’s Senators, Ben Cardin and Chris Van Hollen, have signaled their opposition to the bill.

The Senate bill includes a longer phase out of the Medicaid expansion but would lead to 11 million people losing coverage.  It would effectively cut the Medicaid program more deeply through per-capita caps by setting a lower rate of growth for the newly capped payments than under the American Health Care Act (AHCA).  The Senate would maintain guaranteed coverage for pre-existing conditions. However, it would give states an incentive to waive critical essential health benefits including mental health and substance use treatment coverage.  APA’s Government Relations team has created a three-page fact sheet summarizing how BCRA might affect access to and the delivery of mental health and substance use disorder treatment services.

The Senate discussion draft is expected to undergo changes before it comes up for a vote, which has been delayed until after the July 4 recess due to insufficient support.  The Congressional Budget Office reported on June 26 that 22 million people would lose their health care coverage if the bill is enacted.  It estimated that the bill would reduce the federal deficit by $321 billion over 10 years, with the largest reductions coming from cuts in Medicaid spending.