- The revised version of the Better Care and Reconciliation Act (BCRA) didn't have many substantial changes, and the new analysis from the Congressional Budget Office shows the same general takeaways as the first version: 22 million uninsured by 2026, Medicaid cut by $772 billion and an increase of average deductibles.
- With mounting pressure from President Donald Trump, Senate leadership are still trying to hold a vote of some kind on healthcare this summer. They could push a vote on a version of the BCRA or on straight repeal of the Affordable Care Act (ACA) with no immediate replacement.
- Republicans continued their campaign to discredit the CBO. HHS released its own favorable analysis of an amendment that would allow insurers to offer plans that did not meet ACA requirement as long as they offered at least one plan that does (this amendment has not been scored by the CBO), but numerous health policy experts found the paper unreliable, Vox reports.
While the newest CBO score doesn’t change much of the political discussion currently, it has some pretty drastic illustrations of how high deductibles could get and how much even people with coverage could pay in out-of-pocket expenses. This is mostly because of a change in benchmark plans that creates lower actuarial values.
The revised BCRA would increase premiums in the short term and decrease them in the longer term. This would vary by geography, however, and some people could see “substantially higher premiums,” according to the CBO. Coverage still declines because lower premiums are offset by higher out-of-pocket spending.
The report shows a person with a benchmark plan under the new law in 2026 would have a deductible of about $13,000, which is actually more out-of-pocket spending than current law allows. With such a high deductible, CBO estimates “many people with low income would not purchase any plan even if it had very low premiums.”
The analysis also finds older people would face higher costs than younger people, and thus risk pools could have a disproportionate share of young and healthy beneficiaries.
Senate Leader Mitch McConnell has few options for moving forward on healthcare legislation. The BCRA, even with the latest changes, does not have enough support to pass. Neither does the repeal only plan, at least for now. Republicans intent on fulfilling their campaign promise of repealing the ACA may try to force a vote and put pressure on more moderate members of the party to change their minds and approve a repeal plan. Either way, there will be more to watch from Capitol Hill in the coming months.