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The ACP leads the charge against the Better Care Reconciliation Act

Bob Doherty
Health Policy
June 24, 2017
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President Trump told a group of Republican Senators that the House-based American Health Care Act is “mean” — and on this he surely called it right!

How else would one describe a bill that would take health insurance away from 23 million people, allow states to waive rules requiring insurers to cover people with preexisting conditions at no extra charge, and raise premiums and deductibles to the oldest and sickest patients?  He reportedly urged the Senate to come up with a bill that has more “heart.”

Well, if that was his pitch, the draft bill released by Majority Leader Mitch McConnell is anything but.  It’s heartless and harmful to the most vulnerable in America: women, children, the disabled, the elderly, the sick and the poor; to people suffering from opioid addiction; and especially to the more than 70 million Americans who rely on Medicaid for coverage and access to health care.  Yet the President tweeted this morning in favor of the bill.  Go figure.

In fact, in many respects, the Senate bill, introduced under the Orwellian name “The Better Care Reconciliation Act” (BCRA) of 2017, is meaner and has even less heart than the House bill. It cuts Medicaid by more than the House bill.  It allows states to waive almost all of the protections mandated by the ACA, including coverage for essential benefits (like chemotherapy and treatment for opioid use disorders) and the requirement that insurers spend at least 80 percent of their premiums on patient care services rather than administration and CEO compensation (and it even lifts the $500,000 cap on the amount that an insurer can deduct from taxes for CEO compensation!).  You can read about all of the things that are heartless and harmful in the bill in a letter ACP sent yesterday expressing our strongest possible opposition to it.

Yet Majority Leader McConnell plans to bring it to a vote next week, before Congress adjourns for an Independence Day recess, even though the bill was developed in secret, with no hearings, no committee “mark-ups,” and with no effort to consider the views of ACP and others who actually know something about how a lack of insurance affects patient care.  We won’t know the Congressional Budget Office’s assessment of what the bill would cost, and how many would lose coverage, until just hours before the bill will be voted on.

And make no mistake about it: The bill will pass the Senate unless three Republican Senators have the moral courage to say no to it, and if the Senate passes it, the House almost assuredly will do the same.  Game over.

But we can still win this fight, but only if enough of you, the constituents who your Senators are supposed to represent, speak out now about the harm it will do to patients. Today, issued an all-hands-on-deck legislative alert to our Advocates for Internal Medicine.  It has simple instructions and a sample script to use in making your calls.  We especially need calls to the following Senators: Susan Collins (ME), Lisa Murkowski (AK), Rob Portman (OH), Dean Heller (NV), Dan Sullivan (AK), Jeff Flake (AZ), Cory Gardner (CO), Bob Corker (TN), Bill Cassidy (LA), and Shelley Moore Capito (WV).

Next Wednesday, which may very well be the day before the bill will be voted on in the Senate, ACP’s President will fly to Washington to join with his counterparts with the American Academy of Family Physicians, American Academy of Pediatrics, American Congress of Obstetrics and Gynecology, American Psychiatric Association, and American Osteopathic Association to deliver personalized letter to all 100 U.S. Senators urging a NO vote on the bill, on behalf of the 560,000 physician and medical student members collectively represented by our organizations, and their millions of patients.  (Read the coalition’s statement on the Senate bill.)

We are doing everything in our power to stop the Senate’s heartless and harmful bill from becoming law.

Bob Doherty is senior vice-president, governmental affairs and public policy, American College of Physicians and blogs at the ACP Advocate Blog.

Image credit: Shutterstock.com

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The ACP leads the charge against the Better Care Reconciliation Act
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