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Republican senators on the Better Care Reconciliation Act of 2017 (BCRA)

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For more on healthcare policy, view the following articles:
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Better Care Reconciliation Act of 2017 (Senate bill)
115th Congress on the Better Care Reconciliation Act of 2017
Republican senators on the BCRA
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See also: 115th Congress on the Better Care Reconciliation Act of 2017

On June 22, 2017, the U.S. Senate released the Better Care Reconciliation Act of 2017 (BCRA), its version of the House bill, the American Health Care Act (AHCA). The bill was a reconciliation bill that proposed modifying the budgetary and fiscal provisions of the Patient Protection and Affordable Care Act (ACA), also known as Obamacare. On July 13, 2017, the Senate released a revised version of the bill that included changes, such as $45 billion to address the opioid epidemic and allowing the sale of health plans that do not comply with ACA standards. For detailed information on the BCRA, click here.

On July 17, 2017, after weeks of negotiating the bill, Senate Majority Leader Mitch McConnell (R-Ky.) said that his party was unable to agree on a replacement bill for the ACA, but the bill was revived two days later. During the last week of July, the Senate voted on three major proposals to repeal and replace the ACA. A procedural vote on the BCRA was rejected by a vote of 43-57. A proposal to repeal the ACA and delay the effective date for two years to provide time for a replacement bill failed by a vote of 45-55. The final major amendment—the "skinny bill"—was rejected by a 49-51 vote. It contained the provisions to repeal the requirements for individuals to enroll in health insurance and for employers to offer it, among other provisions.[1][2][3][4][5]

After the skinny bill failed, McConnell said, “it is time to move on,” and he called the final defeat disappointing.[6]

Breakdown of Republican senators' positions on the BCRA

Republican senators who expressed support for the BCRA
Name State
Senate Majority Leader Mitch McConnell Kentucky
Sen. Pat Roberts Kansas
Sen. Richard Shelby Alabama
Sen. Roger Wicker Mississippi


Republican senators who expressed opposition to the BCRA
Name State
Sen. Susan Collins Maine
Sen. Mike Lee Utah
Sen. Jerry Moran Kansas
Sen. Rand Paul Kentucky


Republican senators who were undecided about the BCRA
Name State
Sen. Luther Strange Alabama
Sen. Lisa Murkowski Alaska
Sen. Dan Sullivan Alaska
Sen. Jeff Flake Arizona
Sen. John McCain Arizona
Sen. John Boozman Arkansas
Sen. Tom Cotton Arkansas
Sen. Cory Gardner Colorado
Sen. Marco Rubio Florida
Sen. Johnny Isakson Georgia
Sen. David Perdue Georgia
Sen. Mike Crapo Idaho
Sen. Jim Risch Idaho
Sen. Todd Young Indiana
Sen. Joni Ernst Iowa
Sen. Chuck Grassley Iowa
Sen. Bill Cassidy Louisiana
Sen. John Kennedy Louisiana
Sen. Susan Collins Maine
Sen. Thad Cochran Mississippi
Sen. Roy Blunt Missouri
Sen. Steve Daines Montana
Sen. Deb Fischer Nebraska
Sen. Ben Sasse Nebraska
Sen. Dean Heller Nevada
Sen. Richard Burr North Carolina
Sen. Thom Tillis North Carolina
Sen. John Hoeven North Dakota
Sen. Rob Portman Ohio
Sen. James Lankford Oklahoma
Sen. Jim Inhofe Oklahoma
Sen. Pat Toomey Pennsylvania
Sen. Lindsey Graham South Carolina
Sen. Tim Scott South Carolina
Sen. John Thune South Dakota
Sen. Mike Rounds South Dakota
Sen. Bob Corker Tennessee
Sen. Lamar Alexander Tennessee
Sen. John Cornyn Texas
Sen. Ted Cruz Texas
Sen. Orrin Hatch Utah
Sen. Shelley Moore Capito West Virginia
Sen. Ron Johnson Wisconsin
Sen. John Barrasso Wyoming
Sen. Mike Enzi Wyoming

Senators' comments on the BCRA by state

The comments of each Republican member of the Senate on the BCRA appears below. The healthcare measures that each senator supported also appear below. All Senate Republicans expressed support for making healthcare more affordable by lowering premiums and deductibles.

Alabama

Circle thum up.png Sen. Richard Shelby

During an interview on June 28, 2017, Sen. Richard Shelby (R-Ala.) was asked if he would vote for the BCRA as written. He said, "Well I would vote for it in its present form. I had advocated straight out repeal from the beginning and delay the repeal for a year because that way we could work with the Democrats to get a bipartisan solution."[7]

Shelby expressed support for:[8][7]

  • Making insurance more portable;
  • Expanding health savings accounts;
  • Full repeal of the ACA.

Pending legislation Sen. Luther Strange

On June 22, 2017, Sen. Luther Strange (R-Ala.) released the following statement about the BCRA:[9]

I am encouraged by key provisions in the Senate bill, which would repeal Obamacare’s disastrous individual and employer mandates, repeal taxes on chronic care, health savings accounts, and medical devices, and put Medicaid on a budget that works for individual states. Ultimately, we must take a first step toward delivering on the promise to repeal and replace Obamacare. The people of Alabama deserve insurance coverage that actually means care.[10]

On May 31, 2017, Strange said in a speech, "My main concern is that we take care of the issues that face us here in Alabama. We have a very thin safety net for our most disadvantaged in our Medicaid program, and I want to make sure we're not further disadvantaged in our relationship to other states." During an interview after the speech, Strange said, "Well, I want to make sure that our system is not disadvantaged. We didn't expand our [Medicaid] system like another of other states did, and it wouldn't be fair for Alabama, that did the right thing in protecting its taxpayer dollars to then be penalized somehow by the states that did expand their Medicaid. ... Make sure that we're dealing with addressing the most vulnerable among us, particularly children, elderly, and folks that can't afford it. And that we're also doing things that protect taxpayers money so that people who maybe are not as deserving of some of this government largess are not taking money away from those who need it. Because we don't have very much of a margin of error in our state."[11]

Strange expressed support for:[9]

  • Repealing the individual and employer mandates; and
  • Repealing ACA taxes.

Alaska

Pending legislation Sen. Lisa Murkowski

On June 26, 2017, Sen. Lisa Murkowski (R-Alaska) said she could not vote for the BCRA without more information. She said, "Today I don’t have enough information, I don’t have enough data, in terms of the impact to my state, to be able to vote in the affirmative."[12]

On June 22, 2017, Murkowski released the following statement about the BCRA:[13]

Now that we have full text of the Senate's bill, I will do my due diligence and thoroughly review it. I will be working closely with the state over the next several days to analyze the text and crunch the numbers. It's no secret that health care needs to be reformed, but it needs to be done right. So know that I remain committed to ensuring that all Alaskans have access to affordable, quality health care and will vet this bill through that lens.[10]

On May 4, 2017, after the House passed the AHCA, Murkowski said,[14]

My concerns regarding health-care reform haven’t changed – it must work in a state like Alaska and not pull the rug out from those who currently receive coverage. And while we work to fix the broken current health-care system, I recognize the need to maintain provisions that have worked: the prohibitions on discrimination for pre-existing conditions, no annual or lifetime limits, coverage up to age 26, and Medicaid expansion.[10]

On March 8, 2017, Murkowski said that she opposed the measure to defund Planned Parenthood in the AHCA, but she did not rule out voting in favor of the bill. She said, "I have said continuously and repeatedly that I support the work of Planned Parenthood. I support the continuation of Medicaid funding going to them. I’m not saying anything is a deal-breaker, but I am making very, very clear my position."[15] Murkowski also signed a letter stating that she would not support the AHCA if it included plans to phase out the Medicaid expansion.[16]

Murkowski expressed support for:[14][15]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Eliminating annual or lifetime limits;
  • Covering individuals up to age 26;
  • Protecting the Medicaid expansion; and
  • Funding Planned Parenthood.

Pending legislation Sen. Dan Sullivan

On June 22, 2017, Sen. Dan Sullivan (R-Alaska) released the following statement about the BCRA:[17]

In the coming days, I will read every word of the Better Care Reconciliation Act closely to see if Alaska-specific issues are addressed. Such issues include stabilizing the Alaska insurance market, reversing the trend of dramatically increasing costs, and providing a sustainable and equitable path forward for Medicaid. The current system is not sustainable for Alaskan individuals, families and small businesses. Many Alaskans are being forced to buy insurance that they can’t afford and can’t use. Overall, I believe that we can do better for our state and our country, but I will not vote for a bill that will make things worse for Alaskans.[10]

On May 4, 2017, Sullivan's spokesman Mike Anderson said that Sullivan would work to make sure the AHCA "repeals the individual and employer mandates, works toward reducing costs, provides flexibility to states, protects the Indian Healthcare Improvement Act, and continues to provide coverage for those with pre-existing conditions as well as young adults on their parent’s insurance. ... Alaska is an outlier in terms of costs relative to the rest of the country. Sen. Sullivan will work on the federal level to lower costs, but understands that many of the solutions for these high costs can and will be addressed at the state level."[14]

Sullivan expressed support for:[14]

  • Repealing the individual and employer mandates;
  • Protecting the Indian Healthcare Improvement Act;
  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage; and
  • Covering individuals up to age 26.

Arizona

Pending legislation Sen. Jeff Flake

On June 29, 2017, Sen. Jeff Flake (R-Ariz.) told The Arizona Republic that he was still considering the BCRA and had not decided if he would vote for it. Steve Voeller, a Flake adviser, said, "Senator Flake is focused on how the reform bill will impact Arizonans, not how it will impact any political campaign, but it's no secret that Obamacare has been a disaster for Arizonans and our health-care system."[18]

Flake expressed support for the following:[19]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Expanding health savings accounts (HSAs);
  • Allowing the sale of health insurance across state lines; and
  • Covering individuals up to age 26.

Pending legislation Sen. John McCain

On June 27, 2017, Sen. John McCain (R-Ariz.) released the following statement about the BCRA:[20]

As the Senate moves forward with negotiations on the Better Care Reconciliation Act, I will be working hard to include important measures that address the concerns raised by Governor Ducey and other leaders across our state about the bill’s impact on Arizona’s Medicaid system. Arizona has been nationally recognized for running one of the most efficient and cost-effective Medicaid programs in the country. This legislation should reward states like Arizona that are responsibly managing their health care services and controlling costs – not penalize them. I continue to believe we must repeal and replace Obamacare, which has hit Arizonans with some of the highest premium increases in the nation and left 14 out of Arizona’s 15 counties with only one provider option on the exchanges this year. But we must do so in a way that recognizes our state’s success, protects our economy, and ensures citizens who are most in need do not have the rug pulled out from under them.[10]

On June 22, 2017, McCain released the following statement about the BCRA:[21]

I am closely reviewing the discussion draft of the Senate health care bill released today. My focus is on protecting the people of Arizona, and I am consulting with Governor Doug Ducey and seeking input from Arizonans before making a final decision. Any replacement plan must ensure our citizens have access to affordable and flexible health care, and I look forward to thoroughly examining this legislation and engaging in a robust amendment process in the Senate next week.[10]

Arkansas

Pending legislation Sen. John Boozman

On June 27, 2017, Sen. John Boozman (R-Ark.) commented on the BCRA in the following statement:[22]

Obamacare has failed to live up to its promises and we must replace it with a system that ensures access to affordable, quality care for every American. The working draft being considered by the Senate is one attempt to fix this broken system. As the process moves forward, I will continue to review updates made to the initial draft, study the CBO report, consult with Governor Hutchinson and get important feedback from Arkansans about how this proposal affects families in our state. In addition, I am working with my colleagues on possible amendments that will improve the existing framework as we continue to work towards improving healthcare for all Americans.[10]

Boozman expressed support for the following:[23]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage; and
  • Covering individuals up to age 26.

Pending legislation Sen. Tom Cotton

On March 21, 2017, Sen. Tom Cotton (R-Ark.) said that he could not support the AHCA in the following statement:[24]

Despite the proposed amendments, I still cannot support the House health-care bill, nor would it pass the Senate. The amendments improve the Medicaid reforms in the original bill, but do little to address the core problem of Obamacare: rising premiums and deductibles, which are making insurance unaffordable for too many Arkansans. The House should continue its work on this bill. It's more important to finally get health-care reform right than to get it fast.[10]

On March 9, 2017, Cotton criticized the AHCA in the following series of tweets,[25]

1. House health-care bill can't pass Senate w/o major changes. To my friends in House: pause, start over. Get it right, don't get it fast. ... 2. GOP shouldn't act like Dems did in O'care. No excuse to release bill Mon night, start voting Wed. With no budget estimate! ... 3. What matters in long run is better, more affordable health care for Americans, NOT House leaders' arbitrary legislative calendar.[10]

Colorado

Pending legislation Sen. Cory Gardner

On June 22, 2017, Sen. Cory Gardner (R-Colo.) commented on the BCRA in the following statement:[26]

This is the first I’ve viewed the legislation, so I am beginning to carefully review it as we continue to look at ways to rescue Colorado from the continued negative impacts of the Affordable Care Act on our health care system.[10]

On May 22, 2017, Gardner said,[27]

It’s important that we can find something that can pass, [but] for people to stand around Congress and say the status quo is acceptable — shame on them. [Democrats and Republicans] have to work and find a solution and put in place of the Affordable Care Act something that reduces the cost of care and increases the quality of care. ... We need to make sure the people with pre-existing conditions continue to have coverage and continue to have access to affordable coverage.[10]

On March 6, 2017, Gardner and a group of senators wrote a letter to Senate Majority Leader Mitch McConnell (R-Ky.) stating that they would "not support a plan that does not include stability for Medicaid expansion populations or flexibility for states."[16]

Gardner expressed support for the following:[27][16]

  • Protecting the Medicaid expansion; and
  • Covering individuals up to age 26.

Florida

Pending legislation Sen. Marco Rubio

On June 22, 2017, Sen. Marco Rubio (R-Fla.) released the following statement about the BCRA:[28]

Senator Rubio will decide how to vote on health care on the basis of how it impacts Florida. He has already spoken to Governor Scott, Senate President Negron and Speaker Corcoran about the first draft of this proposal. He has instructed his staff to share with state leaders the first draft and has asked them to run numbers and provide input on how this initial proposal would impact Florida’s Medicaid program and individual insurance marketplace. He has invited them to send staff to Washington next week to help us formulate changes and amendments to this proposal. He will continue to reach out for input and suggested changes from Florida providers, insurers and patient advocate groups.[10]

On June 11, 2017, Rubio was asked if he would vote for the AHCA if it did not defund healthcare organizations that provide abortions, including Planned Parenthood. He said, “I’m always looking for an opportunity to do what’s right on that issue. But that said, I would say that my focus right now is on the broader health care marketplace, getting it fixed. Certainly, if it has that in there, it would be something I’d be supportive of. Whether I condition my vote on it is not something I’m prepared to say.”[29]

On May 23, 2017, Rubio said the following about the AHCA:[30]

So what are my goals? Number one is I want Florida to be treated fairly when it comes to Medicaid. I want to make sure we are not penalized because we didn’t expand. And I want to make sure what other funding formula there is for Medicaid treats Florida fairly but allows it to continue to operate in an innovative way so that we don’t just get more coverage for people but that we get people coverage that actually is better for their health, gets better outcomes.[10]

Georgia

Pending legislation Sen. Johnny Isakson

Sen. Johnny Isakson (R-Ga.) expressed support for:[31]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Selling insurance across state lines; and
  • Allowing small businesses to pool together to form association health plans.

Pending legislation Sen. David Perdue

On June 27, 2017, Sen. David Perdue (R-Ga.) called on the Senate to cancel its August recess if progress was not made on healthcare, the budget, the tax code, and the debt limit. Part of his op-ed appears below.[32]

The United States Senate has just 35 working days until the end of the fiscal year on Sept. 30, and that’s assuming Mondays and Fridays are indeed used for deliberation. One thing is totally clear: There isn’t time to deal with the issues that demand immediate attention. The only appropriate response is to cancel, or heavily truncate, the annual August recess that turns the United States Capitol into a ghost town. ... Five imperatives must be accomplished in short order. First, we have to complete the work on the first phase of repealing Obamacare and fixing our health care system. Second, we have to pass a budget resolution that will work within the reconciliation process for changing the tax code. Third, we have to use the appropriations process to fund the federal government by the end of the fiscal year on Sept. 30. Fourth, we have to deal with our debt limit. The Treasury Department has used extraordinary measures to buy time since the national debt hit its limit of $19.8 trillion in March. Fifth, we have to finally act on our once-in-a-generation opportunity to change our archaic tax code, but we will only be able to do so if we don’t get stuck on the first four priorities. ... If we haven’t made meaningful progress on these priorities by the end of July, then we should pull the plug on the August recess.[10]

On June 26, 2017, Perdue released the following statement about the CBO's score of the BCRA:[33]

When the CBO scored Obamacare in 2010, it overshot its projection of how many people would gain insurance by more than 12 million people. It’s clear the CBO cannot predict the purchasing patterns for millions of Americans. Just like the House CBO score earlier this year, this bureaucratic analysis will do nothing to prevent Obamacare from failing. In Georgia, 96 out of 159 counties have only one insurer within the Obamacare exchanges, leaving hundreds of thousands of Georgians with no competition to choose from for their health insurance. Nationwide, 40 percent of counties will only have one insurer to choose from in the exchange next year. The bottom line is, Obamacare isn’t working and we have to act to put our health care system back on a solid foundation.[10]

On June 23, 2017, Perdue released the following statement about the BCRA:[34]

After reviewing the initial working draft, I believe it includes many substantial fixes to our broken health care system. Obamacare is the law of the land and collapsing under its own weight, and now we are closer than ever before to delivering real relief to millions of Americans struggling under the current system. Obviously, this will not be the final bill, but I’m hopeful that we can resolve the remaining disagreements and deliver a consensus bill that is a vast improvement over Obamacare.[10]

Idaho

Pending legislation Sen. Mike Crapo

On June 22, 2017, Sen. Mike Crapo (R-Idaho) released the following statement about the BCRA:[35]

The bill proposed today in the Senate protects individuals with pre-existing conditions, allows children to stay on their parents’ health insurance through age 26 and does not make changes to Medicare. At the same time, the bill will put Medicaid on a sustainable fiscal path to ensure this necessary safety-net program can continue to serve our most vulnerable patients. The bill allows additional flexibility for states to innovate and better care for beneficiaries. It will also provide the more than 50,000 Idahoans who were prevented from accessing private health insurance under Obamacare with subsidies to purchase a policy that fits their needs. This policy gap of Idahoans and others not having access to insurance is due to some states not expanding their Medicaid pools. This bill now makes coverage possible for those individuals. Insurers are dropping out of the exchanges around the country. The Senate bill immediately stabilizes the insurance market to protect the more than 100,000 Idahoans who purchase their health insurance on the exchange. The bill repeals the burdensome Obamacare mandates, including the individual and employer mandate. Finally, the Senate proposal repeals the taxes which have resulted in higher premiums and health care costs while stunting economic growth. During the Obamacare debate, I offered an amendment to prevent the enactment of any taxes on middle-class families earning less than $250,000. This amendment would have held President Obama to his many campaign promises. The Democrats would not agree to such an amendment, but the Senate will fulfill what I sought to achieve through my amendment in 2009.[10]

Crapo expressed support for the following:[35]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Covering individuals up to age 26;
  • Repealing the individual and employer mandates.

Pending legislation Sen. Jim Risch

On June 22, 2017, Sen. Jim Risch (R-Idaho) told the Idaho Statesman that it was too early for him to comment on the BCRA.[36]

Indiana

Pending legislation Sen. Todd Young

On June 22, 2017, Sen. Todd Young (R-Ind.) released the following statement about the BCRA:[37]

I am reviewing the Senate healthcare discussion draft and speaking with folks at home, but one thing is clear: doing nothing is not an option. Obamacare has failed Hoosiers as prices have skyrocketed, insurers have left the marketplace leaving severely limited choices, and deductibles have risen to a level where, for some, insurance is useless. Just today, we confirmed there will be no insurer that covers the entire state next year. Obamacare’s continuous collapse will eventually leave Hoosiers without insurance. I am committed to improving our nation’s health care system so everyone has the opportunity to access high quality and affordable care.[10]

Iowa

Pending legislation Sen. Joni Ernst

On June 22, 2017, Sen. Joni Ernst (R-Iowa) released the following statement about the BCRA:[38]

The draft was just released, so I am carefully looking through it. However, the reality in Iowa is that continuing the status quo simply isn’t an option because ObamaCare is unsustainable. Wellmark Blue Cross/Blue Shield and Aetna have both pulled out of the Iowa individual market altogether, leaving only one statewide carrier. While I'm pleased that Medica has decided to stay for another year, Iowans in the individual market will likely see a massive rate increase, all because of ObamaCare. This is unacceptable. Traveling across Iowa on my 99 county tour, I hear from Iowans who are looking for affordable, and patient-centered health care solutions; their feedback is critical. I will be closely examining the bill to see how it will affect insurance availability and affordability in 2018 and beyond.[10]

Pending legislation Sen. Chuck Grassley

On June 22, 2017, Sen. Chuck Grassley (R-Iowa) released the following statement about the BCRA:[39]

Congress and the American people have been struggling with the problems with Obamacare since 2010. The Obamacare situation is bad for Iowans in the individual market, including farmers, small business owners, and others. They’re hit hard by soaring Obamacare premium increases. Premiums went up by as much as 43 percent from 2016 to 2017. Now, because of the way Obamacare is designed, Iowans face tremendous uncertainty and anxiety about even having access to a plan in 2018. The need to act is pressing. The Senate discussion draft is available for everyone to review. I’m studying it. I’m looking at the ways it would help Iowans affected by Obamacare’s failures. There will be a full debate before the Senate, with the ability for senators of both parties to offer amendments. We’ll know the official cost estimate soon. I’m glad this process is moving forward, given the problems that continue to get worse with the current law.[10]

Kansas

Circle thumbs down.png Sen. Jerry Moran

On July 17, 2017, Sen. Jerry Moran (R-Kan.) expressed opposition to the revised version of the BCRA in the following tweet:

This closed door process has yielded the BCRA, which fails to repeal the Affordable Care Act or address healthcare's rising costs. For the same reasons I could not support the previous version of this bill, I cannot support this one.[40][10]

On June 27, 2017, Moran said that he did not support the BCRA in the following statement:[41]

The Senate healthcare bill missed the mark for Kansans and therefore did not have my support. I am pleased with the decision to delay the vote — now is the time to take a step back and put the full legislative process to work. I remain committed to working with my colleagues and continuing conversations with patients and providers in Kansas to find a path forward that truely repeals and replaces Obamacare with a plan that makes certain Kansans will have access to more affordable and better quality healthcare.[10]

Moran expressed support for the following:[42]

  • Allowing the sale of health insurance across state lines;
  • Expanding support for community health centers;
  • Expanding health savings accounts (HSAs);
  • Allowing "small businesses and organizations the ability to organize and create larger pools so they can negotiate for better premiums;"
  • Investing in medical research;
  • Addressing prescription drug costs;
  • Promoting preventive healthcare; and
  • Improving Medicare and Medicaid.

Circle thum up.png Sen. Pat Roberts

On June 22, 2017, Sen. Pat Roberts (R-Kan.) released the following statement about the BCRA:[43]

For more than seven years, Obamacare’s mandates, taxes and regulations have wreaked havoc on our health care system and Americans’ pocketbooks. Since the law’s insurance mandates took effect, premiums in Kansas have doubled and insurers have exited the individual insurance market. We cannot continue to allow Obamacare to bring our healthcare system crashing down around our shoulders. The Senate bill protects the very sick, seniors and young people. People with pre-existing conditions will keep their health care. Children under 26 remain on their parents' plans. There are no annual or lifetime limits on coverage. We reduce the deficit; we reform Medicaid, one of the big three entitlements. We eliminate the gap in coverage Obamacare created that hurt too many low-income families. We stabilize collapsing insurance markets. It is time to put ideology aside and move. What is the alternative? Single payer, socialized medicine? The American people don’t want that. We can’t delay. Delay is higher premiums, higher co-pays and little choice. This bill is the best path to immediate relief for patients in 2018. This bill is the best possible bill under very difficult circumstances. As debate moves forward I will work to see that rural healthcare is protected and that we achieve our ultimate goal of improving access to quality care for all Americans.[10]

Roberts expressed support for the following:[43]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Covering individuals up to age 26;
  • Eliminating annual and lifetime limits on coverage; and
  • Reforming Medicaid.

Kentucky

Circle thum up.png Senate Majority Leader Mitch McConnell

On June 22, 2017, Senate Majority Leader Mitch McConnell (R-Ky.) expressed his support for the BCRA. Part of his statement appears below.[44]

We agree on the need to free Americans from Obamacare’s mandates, and policies contained in the discussion draft will repeal the individual mandate, so Americans are no longer forced to buy insurance they don’t need or can’t afford. And repeal the employer mandate, so Americans no longer see their hours and take-home pay cut by employers because of it. We agree on the need to improve the affordability of health insurance, and policies contained in the discussion draft will eliminate costly Obamacare taxes that are passed on to consumers, so we can put downward pressure on premiums. Expand tax-free health savings accounts and deploy targeted tax credits, so we can help defray out-of-pocket costs. And shift power from Washington to the states, so they have more flexibility to provide more Americans with the kind of affordable insurance options they actually want. We agree on the need to stabilize the insurance markets that are collapsing under Obamacare as well, and policies contained in the discussion draft will implement stabilization policies, so we can bring financial certainty to insurance markets and hope to Americans who face the possibility of limited or zero options next year under Obamacare. And ultimately transition away from Obamacare’s collapsing system entirely, so more Americans will not be hurt. We also agree on the need to strengthen Medicaid, preserve access to care for patients with preexisting conditions, and allow children to stay on their parents’ health insurance through the age of 26. ... When legislation does come to the floor, it will present Senate Democrats with another opportunity to do what’s right for the American people. They can choose to keep standing by as their failing law continues to collapse and hurt more Americans, but I hope they will join with us instead to bring relief to the families who have struggled under Obamacare for far too long. Either way, we have to act. Because Obamacare is a direct attack on the middle class, and American families deserve better than its failing status quo — they deserve better care. That’s just what we’re going to continue working to bring them.[10]

McConnell expressed support for the following:[44]

  • Repealing the individual and employer mandates;
  • Eliminating ACA taxes;
  • Expanding tax-free health savings accounts;
  • Strengthening Medicaid;
  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage; and
  • Covering individuals up to age 26.

Circle thumbs down.png Sen. Rand Paul

On July 16, 2017, Sen. Rand Paul (R-Ky.) expressed his opposition to the revised version of the BCRA in the following statement:

You know, I think the longer the bill's out there, the more conservative Republicans are going to discover that it's not repeal. And the more that everybody's going to discover that it keeps the fundamental flaw of Obamacare. It keeps the insurance mandates that cause the prices to rise, which chase young, healthy people out of the marketplace, and leads to what people call adverse selection, where you have a sicker and sicker insurance pool and the premiums keep rising through the roof. And one of the amazing things to me is, for all the complaints of Republicans about Obamacare, we keep that fundamental flaw. And the reason you know Republicans acknowledge this is they make a giant insurance fund to subsidize those prices. Basically, they're subsidizing the death spiral of Obamacare. So for all Republicans' complaints about the death spiral of Obamacare, they don't fix it, they simply subsidize it with taxpayer monies, which I just don't agree with at all.[45][10]

On June 28, 2017, Paul sent a letter to President Donald Trump, Senate Majority Leader Mitch McConnell (R-Ky.), and other Senate leaders outlining the changes he wanted to be made to the BCRA. His requests appear below.[46]

1. Association Health Plans – While I appreciate the inclusion of Small Business Health Plans in the BCRA, I believe improvements could be made to expand upon this provision to allow for greater freedom for individuals and small businesses to pool together for the purpose of obtaining health insurance coverage.
a. The bill currently allows for self-employed individuals to participate in small business health plans. However, I would suggest that the language be changed to allow any individual, including self-employed individuals, to form associations for the purpose of purchasing group health insurance.
b. Furthermore, I would suggest that small business plans or association health plans be allowed to self-insure like other large employer groups are able to do under ERISA. Self-insurance provides significant flexibilities to create innovative plan designs free from many mandates.
c. Finally, I believe we have an opportunity to completely free the group market from unnecessary ACA regulations, and restore HIPAA and ERISA regulation over the entire group market, including for association health plans.

2. Insurance Company Bailouts – For years, conservatives have been concerned with Obamacare’s bailout of the insurance companies through various programs designed to backfill losses the insurers take in the Obamacare exchanges, while they make huge profits in the group markets. In fact, insurance company profits were $8 billion per year in 2008, and have risen to $15 billion in 2015. The BCRA’s payment of Obamacare’s cost-sharing reductions, as well as its stability funds, would provide another $136 billion in funding to pay insurance companies to participate in these markets. I urge you to reconsider this insurance company bailout.

3. Premium Tax Credits – In 2015, Senate Republicans voted to eliminate the Obamacare premium tax credits. Now, the BCRA simply proposes to modify and extend them to new populations. I urge you to reconsider the advanced, refundable nature of this entitlement.

4. Continuous Coverage Requirement – The continuous coverage requirement of the BCRA, which imposes a mandatory 6 month waiting period for individuals with a lapse of 63 days or more in coverage, simply appears to be a Republican version of the individual mandate. This continues the top-down approach that has led to increased premiums and has not changed behavior of the young and healthy who are priced out of the market, and those who game the system to purchase insurance after they become sick. I urge you to remove the mandate and simply allow insurance companies to impose a waiting period.[10]

On June 22, 2017, Sens. Paul, Mike Lee (R-Utah), Ted Cruz (R-Texas), and Ron Johnson (R-Wis.) released the following joint statement opposing the BCRA:[47]

Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor. There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.[10]

On June 22, 2017, Paul said that he would not vote for the BCRA unless changes were made. His statement appears below.[48]

The current bill does not repeal Obamacare. It does not keep our promises to the American people. I will oppose it coming to the floor in its current form, but I remain open to negotiations.[10]

On March 6, 2017, Paul called for a full repeal of the ACA in the following statement:[49]

We call on Congressional leaders to keep their word to the American people, to push a real repeal of ObamaCare, and to do it now. The only way to really do that in a way that ensures passage is to move forward with a 'clean' repeal, such as the 2015 repeal bill. ... If anyone tells you there isn’t a plan that can both keep our promises to repeal, and work in a bipartisan, open way for replace, tell them conservatives have a plan to do just that. Now let’s hope our leadership will listen, because it is the only way they’re going to get our votes.[10]

Paul expressed support for:

  • A full repeal of the ACA;[50]
  • Eliminating refundable tax credits to help low-income people buy private insurance plans;[51]
  • Repealing all of the ACA's insurance regulations;[52]
  • Eliminating a provision from the BCRA "that would require individuals who miss an insurance payment to wait six months before being able to sign back up for insurance;"[52]
  • Creating association health plans; and[46]
  • Eliminating cost-sharing payments;[46]

Louisiana

Pending legislation Sen. Bill Cassidy

On June 22, 2017, Sen. Bill Cassidy (R-La.) released the following statement about the BCRA:[53]

I was just briefed on the newly released health care legislation. The bill includes elements of the Patient Freedom Act and the MAC Act—which is positive. I will study the bill to determine whether it fulfills President Trump’s campaign promises to lower premiums, maintain coverage and protect those with preexisting conditions without mandates.[10]

On May 11, 2017, Cassidy said that the AHCA should protect individuals with pre-existing conditions, remove the individual mandate to purchase health insurance, and lower premiums. Cassidy said, “We are going to protect those with pre-existing conditions, but we will do it by lowering premiums and not by giving crumby coverage, but rather by having adequate coverage. If our approach passes the Kimmel test then we feel like it is a way to go.” After his son was born with a congenital heart disease, late-night talk show host Jimmy Kimmel said that all children born with health problems should be able to get the care they need. Cassidy said that he would use the Kimmel test to make sure that individuals with pre-exisiting conditions could get coverage and are not denied insurance after they reach a lifetime or annual limit set by an insurance company.[54][55]

Cassidy also called on Democrats to help reform healthcare. He said, “We don’t need 12 Democrats, we don't need eight Democrats, we can have three Democrats, four Democrats, anyone who cares enough about the people in their state, and their premiums rising 20 to 40 percent per year, that they will put aside all the pressure from a political base and say that ‘the people of my state are more important than the political pressure I may feel’ and they will step forward to influence the final product."[54][55]

Cassidy expressed support for the following:[54][55]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage; and
  • Removing the individual and employer mandates.

Pending legislation Sen. John Kennedy

On June 27, 2017, after meeting with Republican leaders to discuss the BCRA, Sen. John Kennedy (R-La.) released the following statement:[56]

I had a productive meeting at the White House this afternoon with President Trump, Vice President Pence, my colleagues in the Senate, and Trump administration Chief of Staff Reince Priebus about finding viable solutions for our broken health care system. As premiums continue to rise, insurers drop out of exchanges, and states continue to suffocate under the rising cost of Medicaid, it is more important than ever to come together and stop the unmitigated disaster that is Obamacare. I will continue to work towards a better, more sensible health care system that benefits all Americans.[10]

Maine

Circle thumbs down.png Sen. Susan Collins

On July 16, 2017, Sen. Susan Collins (R-Maine), who said that she would not vote on a motion to proceed to debate on the revised version of the BCRA, criticized Senator Ted Cruz's (R-Texas) amendment that proposed allowing insurance providers to sell plans that do not meet ACA requirement as long as they sell one plan that meets the requirements. Collins said, “Senator Cruz’s approach is not the answer. There is a way to deal with this, and that is by creating a reinsurance pool for people with pre-existing conditions."[57]

On June 26, 2017, in a series of tweets, Collins explained why she was going to vote against a scheduled motion to proceed (mtp) to debate the BCRA. She wrote, "I want to work w/ my GOP & Dem colleagues to fix the flaws in ACA. CBO analysis shows Senate bill won't do it. I will vote no on mtp. CBO says 22 million people lose insurance; Medicaid cuts hurt most vulnerable Americans; access to healthcare in rural areas threatened. Senate bill doesn't fix ACA problems for rural Maine. Our hospitals are already struggling. 1 in 5 Mainers are on Medicaid."[58]

On May 4, 2017, Collins released the following statement about the AHCA:”[59]

Our current health care system is under considerable stress. In several states, the individual insurance market is on the verge of collapse, leaving consumers with no insurer willing to sell them insurance that qualifies for ACA subsidies. In many other states, those who do have coverage are experiencing large increases in premium costs, deductibles, and co-pays. Moreover, the ACA has been in full effect for years, yet nearly 30 million people still do not have health insurance coverage, and many find their choice of insurance and health care providers severely restricted. Although I will carefully review the legislation the House passed today, at this point, there seem to be more questions than answers about its consequences. As I review the House bill, the key questions for me include:
  • What will be the effect on the people of Maine, including those who rely on the ACA for their health insurance coverage?
  • What will Mainers pay compared to their costs under the ACA? I am particularly concerned about the effect on low-income older individuals living in rural areas. The House bill's tax credits do not adequately take into account income levels, or geographical differences in health care costs.
  • Exactly how does the bill treat individuals with pre-existing conditions? There should be no barrier to coverage for pre-existing conditions as long as people enroll and pay their premiums.
  • Will certain vital services for special education students be affected by the changes the bill makes to Medicaid?
  • How will the changes in Medicaid affect individuals and families, states, hospitals, and other health care providers?
  • Finally, will the bill make insurance more affordable and increase access to quality care?

In order to answer these questions and others, we really need the Congressional Budget Office to assess the impact of the bill on coverage, costs, and premiums. That has not yet been completed. This is an extremely important debate with significant implications for millions of Americans. We need to spend the time necessary to get this right and work to achieve the goal of expanding access to health care that is truly affordable and accessible.[10]

On March 16, 2017, Collins said,[60]

This is not a bill I could support in its current form. It really misses the mark. ... This bill doesn’t come close to achieving the goal of allowing low-income seniors to purchase health insurance. We don’t want to in any way sacrifice coverage for people who need it the most. ... Older people living in rural America would be really left behind.[10]

When asked about the AHCA, on March 8, 2017, Collins said,[61]

I do not think it would be well received in the Senate." According to Yahoo News, "The Maine senator also strongly opposes defunding women’s health services and abortion provider Planned Parenthood in any health care bill, since 10,000 women in her state use Planned Parenthood for cancer screenings and other health care." Collins said, "Where are those people going to go? And why should those women have to change doctors? That doesn’t make sense.[10]

Collins expressed support for:

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;[59]
  • Protecting individuals in rural areas; and
  • Fuding Planned Parenthood.[61]

Mississippi

Pending legislation Sen. Thad Cochran

Sen. Thad Cochran (R-Miss.) did not say if he would vote for the BCRA. On June 26, 2017, Chris Gallegos, Cochran's communications director, said, “Since last Thursday, the Cochran offices have received approximately 224 constituent calls against and two in favor of discussion draft of the healthcare bill."[62]

Circle thum up.png Sen. Roger Wicker

On June 27, 2017, Sen. Roger Wicker (R-Miss.) expressed his support for the BCRA, saying, “I think thousands and thousands of Mississippians would have a chance to get tax credits to buy better insurance. I’m eager to see it debated. I think we very much need to proceed to the bill."[63]

On June 22, 2017, Wicker released the following statement about the BCRA:[64]

In almost every regard, this draft legislation represents another step to move us away from the unworkable aspects of Obamacare and toward a smaller government approach. If enacted, Americans would be far better off than they are under the failing Obamacare status quo. I am confident that we will have an opportunity to make additional improvements to this proposal, addressing both the astronomical increases in health insurance premiums and the lack of choices in the market.[10]

Missouri

Pending legislation Sen. Roy Blunt

On June 22, 2017, Sen. Roy Blunt (R-Mo.) released the following statement on the BCRA:[65]

Year after year, Missouri families have had to worry about their health plans being canceled, their options and access being taken away, and their premiums going up. In our state, 25 counties have no companies willing to offer health care coverage on the exchanges next year and premiums are up 145 percent, on average, since 2013. The status quo is far from what was promised and it is unsustainable. The draft health care legislation preserves access to care for people with pre-existing conditions, strengthens Medicaid and does not change Medicare, gives people more health insurance choices, and allows people to stay on their family health insurance plan until they are 26. Members of both parties will have an opportunity to offer amendments as the process moves forward. I will carefully review the final legislation with a focus on how it will help address the problems Missourians are facing under Obamacare. American families need a more reliable and affordable health care system, and this bill takes important steps in that direction.[10]

Blunt expressed support for the following:[65]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Covering individuals up to age 26; and
  • Strengthening Medicaid.

Montana

Pending legislation Sen. Steve Daines

On June 30, 2017, Sen. Steve Daines (R-Mont.) commented on Medicaid, saying that he supported the program in the following instances: “Especially for those for whom Medicaid was originally intended, the blind, the disabled, pregnant moms, elderly that are pre-Medicare, and importantly children. Children are the #1 beneficiaries of Medicaid in Montana and across the nation.” He said that these groups of people needed to be protected by the healthcare bill in order for him to vote for it. He added, “There’s more than just that. But I’ve got to check those 3 boxes.”[66]

On June 28, 2017, Daines told a constituent during a tele-townhall that he supported redirecting funds that go to healthcare organizations that also provide abortions—like Planned Parenthood—to community health centers. Daines said, “I am pro-life. I'll stand and fight for those who are most vulnerable in our society. That is the unborn, that is the elderly, that is the disabled."[67]

On June 24, 2017, Daines said that he would wait to hear from his constituents before deciding whether to vote for the BCRA. He said, “What Montanans have told me they want to see, first and foremost, is a reduction in premiums, the affordability question. Number two, taking care of those with pre-existing conditions, that they have access to care and affordable care. And number three, very important for Montana is, we are one of the Medicaid expansion states, is that we save Medicaid and protect Medicaid.”[68]

Daines expressed support for the following:[66][67][68]

  • Protecting Medicaid;
  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Repealing the individual mandate; and
  • Redirecting funding from healthcare organization that also provide abortions to community health centers.

Nebraska

Pending legislation Sen. Deb Fischer

On June 30, 2017, Sen. Deb Fischer (R-Neb.) did not say if she supported the BCRA. Instead, she said, “I hear from thousands and thousands of Nebraskans on both sides of the issue. But the majority of Nebraskans elected Donald Trump. They have elected a congressional delegation who has campaigned and stood for repeal and replace Obamacare.”[69]

Pending legislation Sen. Ben Sasse

On June 30, 2017, Sen. Ben Sasse (R-Neb.) sent a letter to President Donald Trump asking him to call on Congress to repeal and then replace the ACA, if members of Congress were unable to create a final repeal and replace bill by July 10. He also asked Trump to cancel the August recess so that senators could work on a healthcare reform package. Part of his letter appears below.[70]

The Senate will next be in legislative session on Monday, July 10. If we don’t get to agreement on a combined, comprehensive ObamaCare repeal and replace plan by that day, I humbly suggest that you publicly call on the Congress to do two things: (1) to immediately repeal as much of ObamaCare as is possible under Congressional budget reconciliation rules, and then (2) to cancel the scheduled August state work period and instead to spend that month working through regular order, six days per week, writing a health reform package with a vote to be scheduled on Labor Day. You campaigned and won on the repeal of ObamaCare. So did every Republican senator. We should keep our word. Also like you, almost every Republican senator believes that health reform was needed before Democrats passed ObamaCare in 2010, and fundamental reform is still needed today. While we strongly disagree with Democrats that health coverage and premiums would be improved by more federal intrusion into health finance and delivery markets – and the nation’s tragic experience with ObamaCare’s broken promises supports our view – true reform was nonetheless needed then and is still needed now. On the current path, it looks like Republicans will either fail to pass any meaningful bill at all, or will instead pass a bill that attempts to prop up much of the crumbling ObamaCare structures. We can and must do better than either of these – both because the American people deserve better, and because we promised better.[10]

On June 25, 2017, Sasse said that the BCRA would not repeal the ACA and would mostly alter Medicaid. He said, “This is largely a Medicaid reform package. ... Republicans have 52 votes in the Senate, we don’t have 60, and to do major legislation requires 60 votes. So this is not a full repeal or full replace piece of legislation, and that’s dictated by a whole bunch of circumstances. So we are having a conversation about something that’s much smaller than that.” Sasse declined to say if he would vote for the BCRA.[71]

Nevada

Pending legislation Sen. Dean Heller

On June 24, 2017, Sen. Dean Heller (R-Nev.) Heller said that he would not vote for the BCRA. He said, "It's simply not the answer. And I'm announcing today that in this form, I simply will not support it."[72]

On June 22, 2017, Heller released the following statement on the BCRA:[73]

Throughout the health care debate, I have made clear that I want to make sure the rug is not pulled out from under Nevada or the more than 200,000 Nevadans who received insurance for the first time under Medicaid expansion. At first glance, I have serious concerns about the bill’s impact on the Nevadans who depend on Medicaid. I will read it, share it with Governor Sandoval, and continue to listen to Nevadans to determine the bill’s impact on our state. I will also post it to my website so that any Nevadans who wish to review it can do so. As I have consistently stated, if the bill is good for Nevada, I’ll vote for it and if it’s not – I won’t.[10]

On May 4, 2017, Heller expressed opposition to the AHCA in the following statement:[74]

I want to repeal Obamacare in a way that benefits Nevadans, but I think that the current bill falls short. I will not support it in its current form in the Senate, and am confident that what the Senate considers and approves will be different from the House bill. We cannot pull the rug out from under states like Nevada that expanded Medicaid and we need assurances that people with pre-existing conditions will be protected.[10]

Heller expressed support for:[50][75]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • A seven-year phase out of Medicaid, instead of three; and
  • Allowing customers to purchase insurance across state lines.

North Carolina

Pending legislation Sen. Richard Burr

On June 22, 2017, Sen. Richard Burr (R-N.C.) released the following statement on the BCRA:[76]

This draft legislation outlines a number of initiatives that are good for North Carolina. While not perfect, the bill does provide the funding we need to support our most vulnerable North Carolinians. I’m encouraged that it keeps the law protecting people with pre-existing conditions. The legislation also reverses $31 billion in cuts made to Medicaid by Obamacare, extends millions of dollars in funding to our Community Health Centers, and provides $2 billion to the fight against the opioid epidemic.[10]

Burr expressed support for the following:[76]

  • Covering individuals up to age 26;
  • Providing tax credits to help low-income individuals afford healthcare;
  • Repealing the medical device tax;
  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage; and
  • Funding for opioid addiction treatment.

Pending legislation Sen. Thom Tillis

On June 22, 2017, Sen. Thom Tillis (R-N.C.) released the following statement on the BCRA:[77]

Health care is a critically important issue that affects every single American, and I’ve heard countless stories from North Carolinians who have had their lives upended by Obamacare, from hardworking parents unable to afford skyrocketing premiums to insure their families to small business owners who have been forced to cut hours or even let go of employees because of the law’s costly mandates. As I’ve said repeatedly, any replacement plan must be a net improvement over Obamacare, and I look forward to carefully reviewing the draft legislation over the next several days.[10]

North Dakota

Pending legislation Sen. John Hoeven

On July 6, 2017, Sen. John Hoeven (R-N.D.) expressed his opposition to the BCRA in the following statement:[78]

Families in North Dakota and across the country have seen increased premiums and deductibles, as well as limited health care options as a result of Obamacare. Addressing the problems with Obamacare and reforming our health care system will be a process, not one bill. I do not support the Senate health care bill in its current form and am especially concerned by the CBO’s analysis of the bill’s impact on Medicaid. We are meeting with health care leaders from around the state to gather input and continue working on health care reform that provides greater access to health care and more affordable health insurance.[10]

On June 28, 2017, Hoeven released the following statement about the BCRA:[79]

Obamacare has raised costs and limited health care options for families in North Dakota and across the nation. We need to make reforms in order to provide greater access to health care and more affordable health insurance. As I said yesterday, the CBO report shows that we have more work to do. I have concerns about the Senate draft legislation, but will continue working to improve it to help ensure that it provides a smooth transition away from Obamacare and toward a health care system that provides greater access to health coverage for low-income individuals either through Medicaid or tax credits based on age and income that will make health insurance more affordable.[10]

On June 22, 2017, Hoeven released the following statement about the BCRA:[80]

The overall goal of health care reform legislation should be to provide Americans with access to patient-centered health care and health insurance at an affordable rate. We will review this legislation to determine whether it meets this standard and we also want to see a CBO score on the bill. We need to stabilize the health insurance market to make it more competitive so consumers have access to better and more affordable health care policies. At the same time, we need to ensure that low-income individuals have access to health insurance either through Medicaid or through tax credits based on age and income.[10]

On May 26, 2017, Hoeven (R-N.D.) said,[81]

We want states to have flexibility, but that’s why you need some kind of federal support or backstop like a risk pool or reinsurance so that people are comfortable that for chronic illness and pre-existing conditions, there’s going to be coverage there and that their premiums won’t become unaffordable.[10]

Hoeven expressed support for:[81][80][82][78]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Ensuring "that low-income individuals have access to health insurance either through Medicaid or through tax credits based on age and income;"
  • Increasing transparency of medical pricing;
  • Preventing Medicaid and Medicare fraud;
  • Promoting "the purchase of long-term care insurance through tax credits to relieve the pressure of these costs on Medicaid;"
  • Health savings accounts;
  • Increasing "health insurance opportunities for low-income children by assisting eligible children enrolled in the CHIP Program;"
  • Enacting "tort reform legislation that limits frivolous medical lawsuits while ensuring patient safety and quality of care is not compromised;" and
  • Stabilizing "the health insurance market to make it more competitive so consumers have access to better and more affordable health insurance plans."

Ohio

Pending legislation Sen. Rob Portman

On June 27, 2017, Sen. Rob Portman (R-Ohio) expressed opposition to the BCRA in the following statement:[83]

As I’ve said many times, the Affordable Care Act is not working for many Ohio families and small businesses. I am committed to creating a better health care system that lowers the cost of coverage, provides access to quality care, and protects the most vulnerable in our society. The Senate draft before us includes some promising changes to reduce premiums in the individual insurance market, but I continue to have real concerns about the Medicaid policies in this bill, especially those that impact drug treatment at a time when Ohio is facing an opioid epidemic. For months, I have engaged with my colleagues on solutions that I believe are necessary to ensure that we improve our health care system and better combat this opioid epidemic. Unfortunately, the Senate draft falls short and therefore I cannot support it in its current form. In the days and weeks ahead, I’m committed to continue talking with my colleagues about how we can fix the serious problems in our health care system while protecting Ohio’s most vulnerable citizens.[10]

On May 4, 2017, Portman expressed opposition to the AHCA in the following statement:[84]

The status quo on health care is unsustainable. Premiums and deductibles continue their steep climb, and the skyrocketing cost of health care is hurting Ohio families and small businesses. There’s only one insurance company in more than one third of Ohio counties, which is leaving Ohioans with fewer choices and higher costs. Congress must take responsible action that lowers health care costs, but these changes must be made in a way that does not leave people behind. I’ve already made clear that I don’t support the House bill as currently constructed because I continue to have concerns that this bill does not do enough to protect Ohio's Medicaid expansion population, especially those who are receiving treatment for heroin and prescription drug abuse. We have an opioid crisis in this country, and I’m going to continue to work with my colleagues on solutions that ensure that those who are impacted by this epidemic can continue to receive treatment.[10]

On March 6, 2017, Portman and a group of senators wrote a letter to Senate Majority Leader Mitch McConnell (R-Ky.) stating that they would "not support a plan that does not include stability for Medicaid expansion populations or flexibility for states."[16]

Portman expressed support for the following:

  • A seven-year phaseout of Medicaid, instead of three; and[52]
  • Increased funding for opioid addiction treatment.[85]

Oklahoma

Pending legislation Sen. Jim Inhofe

On June 22, 2017, Sen. Jim Inhofe (R-Okla.) released the following statement about the BCRA:[86]

Oklahomans are hurting from Obamacare. With just one insurer left in the entire state, Obamacare premiums rose 76 percent last year and they have risen 201 percent since 2013. The Republican-led Senate is committed to repealing and replacing Obamacare, which will help to stabilize collapsing insurance markets, make health insurance more affordable and free the American people from the burdensome Obamacare mandates. I am continuing to review the details of the bill text released today and look forward to working with my colleagues in the coming days to address the crisis of Obamacare.[10]

Inhofe expressed support for the following:[87]

  • Repealing the individual mandate;
  • Repealing the ACA's medical device tax;
  • Portable health insurance; and
  • Medical malpractice reform.

Pending legislation Sen. James Lankford

On June 22, 2017, Sen. James Lankford (R-Okla.) released the following statement about the BCRA:[88]

Insurance markets are collapsing under the Affordable Care Act. As time goes on, more insurance companies pull out of the Obamacare exchanges and healthcare costs continue to rise. This year, about one-third of the counties across America, including all 77 counties in Oklahoma, have just one choice of insurer in the exchange. Oklahoma is experiencing some of the most shocking rate hikes in the nation, with a premium increase of 76 percent just this year, on top of a 35 percent increase last year. As the market gets ready to release plans and prices for 2018, it’s more important than ever to stop the continued harm from Obamacare and improve healthcare choices and outcomes for the American people. Congress should pass a bill that provides a smooth transition from the Affordable Care Act to a better system that provides more affordable coverage options for everyone, with the goal in mind of doing no harm to current enrollees as the transition occurs. In the days ahead, I will analyze this healthcare working draft to ensure that it is affordable and practical for Oklahomans of all socioeconomic levels and all health conditions.[10]

Pennsylvania

Pending legislation Sen. Pat Toomey

On June 29, 2017, Sen. Pat Toomey (R-Pa.) commented on the proposal to keep the ACA's 3.8 percent tax on investment income, saying, “I don’t remember anybody going around saying, ‘Oh, except for these job-killing tax increases.' So I expect that we’ll be repealing all the taxes.”[85]

On June 22, 2017, Toomey released the following statement about the BCRA:[89]

Obamacare is failing Pennsylvanians. As taxes, premiums and deductibles continue to skyrocket, choices and access to care have dwindled. The draft bill unveiled in the Senate today strikes me as an important and constructive first step in repealing Obamacare and replacing it with a better, stable, consumer-driven health care system for all Pennsylvanians. This measure does not pull the rug out from anyone currently covered by Obamacare, and keeps the Medicaid expansion covering able-bodied, working-age, childless adults, while asking the states to eventually contribute their fair share for this care. Further, this bill works to ensure Medicaid is sustainable for future generations by modestly reducing, seven and a half years from now, the rate at which federal spending on the program will grow.[10]

Toomey expressed support for the following:[85][90]

  • Repealing all of the ACA's taxes;
  • "[G]iving individuals who buy their own health insurance the same tax benefits that employers enjoy when they buy health insurance for their employees;"
  • Allowing the sale of health insurance across state lines;
  • Enacting comprehensive tort reform;
  • Allowing small businesses and groups "to join together to form association health plans to lower the cost of providing health care;" and
  • Protecting individuals with pre-existing conditions by helping "facilitate a market for renewable health plans."

South Carolina

Pending legislation Sen. Lindsey Graham

On June 22, 2017, Sen. Lindsey Graham (R-S.C.) released the following statement about the BCRA:[91]

Every day brings fresh evidence that Obamacare is moving toward eventual collapse. There are now more than 40 counties across the United States which will not have a health care provider offering coverage on the Obamacare exchange. In South Carolina, the situation is not much better as we are down to one provider on our Obamacare exchange, and that provider has expressed doubts about whether they can afford to continue to offer their product. I would prefer to address health care reform in a bipartisan manner, but Democrats are unwilling to work with President Trump and Congressional Republicans to fix the mess they created. Finally, South Carolinians want Obamacare repealed and replaced with something better. Only after a careful review of the legislation will I be able to determine if this bill achieves those goals.[10]

Pending legislation Sen. Tim Scott

Sen. Tim Scott (R-S.C.) expressed support for the following:[92]

  • Allowing the sale of health insurance across state lines;
  • Providing businesses and the self-employed a tax deductions for insurance premiums; and
  • Creating high-risk pools for individuals with pre-existing conditions;

South Dakota

Pending legislation Sen. Mike Rounds

On June 23, 2017, Sen. Mike Rounds (R-S.D.) released the following statement about the BCRA:[93]

One thing we know with certainty is this proposal is already better than Obamacare, a system that has failed the American people and must be fixed before it’s too late. The reason we need to fix Obamacare in short order is because insurance underwriters are planning for 2018; they need some certainty as to what the health care marketplace will look like so they can calculate risks and set rates. Right now under Obamacare, South Dakotans’ premiums are expected to increase nearly 40 percent next year on the individual market. Premiums have already increased 124 percent over the past four years for South Dakota families. We need to act quickly and responsibly to provide relief from Obamacare – it has become a moral obligation. When families are spending more on health care premiums than their home mortgage, that’s unsustainable. ... The Senate health care bill also takes steps to reform and safeguard Medicaid by allowing states to have more flexibility in administering the program, makes no changes to coverage for preexisting conditions, and provides a stable transition as we move away from Obamacare to a new, more competitive market. Additionally, it removes the individual and employer mandates, so Americans aren’t forced to pay for expensive health insurance that they don’t like, want or need. I was pleased that the discussion draft includes a number of provisions that I’ve said all along need to be included in any health care bill we put forward. It would allow children to stay on parents’ plans until age 26 and allows individuals with preexisting conditions to keep their coverage as long as they stay insured. It is important that any replacement plan approved by Congress allows for a transition period, where people can move to different plans without losing health care coverage. It maintains assurances for guaranteed portability, guaranteed renewability and it provides reassurance that individuals with serious illnesses will always have access to coverage.[10]

Rounds expressed support for the following:[93]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Providing flexibility to states to administer Medicaid;
  • Eliminating the individual and employer mandates; and
  • Covering individuals up to age 26.

Pending legislation Sen. John Thune

On June 22, 2017, Sen. John Thune (R-S.D.) expressed support for the BCRA in the following statement:[94]

Under Obamacare, Americans are facing higher premiums, higher deductibles, and fewer choices. That’s why watching from the sidelines as Obamacare continues to fail is simply not an option. The draft health care bill released today will help stabilize markets that are already collapsing, improve the affordability of health care, preserve access to care for those with pre-existing conditions, and sustain Medicaid while also ensuring that those who rely on the program do not have the rug pulled out from under them. This legislation also includes a more generous tax credit that is targeted toward those who need it the most, especially low-income seniors. It’s time to rescue Americans from the mess that Obamacare created.[10]

Thune expressed support for the following:[94]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Providing flexibility to states to administer Medicaid; and
  • Tax credits for low-income individuals to purchase health insurance.

Tennessee

Pending legislation Sen. Lamar Alexander

On June 22, 2017, Sen. Lamar Alexander (R-Tenn.) released the following statement on the BCRA:[95]

To begin with, the draft Senate health care bill makes no change in the law protecting people with pre-existing conditions, no change in Medicare benefits, and increases Medicaid funding— that’s TennCare—at the rate of inflation. Let me repeat: it makes no change in the law protecting people with pre-existing conditions, no change in Medicare benefits, and increases funding for Medicaid—that’s TennCare—at the rate of inflation.[10]

Alexander expressed support for the following:[95]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Continuing federal cost-sharing payments;
  • Repealing the medical device tax;
  • Repealing the individuals and employer mandates; and
  • Increased funding for opioid addiction treatment.

Pending legislation Sen. Bob Corker

On June 22, 2017, Sen. Bob Corker (R-Tenn.) released the following statement about the BCRA:[96]

Under the current health care system, families in Tennessee and across our country face rising costs and have limited choices. Congress has a responsibility to resolve these issues and stabilize the individual insurance market, and over the next several days, I will take time to fully review the legislative text and seek input from a wide range of stakeholders across our state. I will make a final decision based on whether this legislation, on the whole, is better than what is in place today.[10]

Texas

Pending legislation Sen. John Cornyn

On June 22, 2017, Sen. John Cornyn (R-Texas) expressed support for the BCRA in the following statement:[97]

This, I believe, is a framework for better care. But we're going to continue to discuss this plan and talk to anyone who is willing to talk to us and work with us. If there is a way the bill can be strengthened, I am open to it. But the status quo isn't working, and our Democratic colleagues know it.[10]

Cornyn expressed support for the following:[97]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Repealing the individual and employer mandates;
  • Providing tax credits to help low-income individuals afford healthcare;
  • Increasing Medicaid funding for individuals with mental illness; and
  • Providing new funding to combat opioid abuse.

Pending legislation Sen. Ted Cruz

On June 22, 2017, Sens. Ted Cruz (R-Texas), Mike Lee (R-Utah), Rand Paul (R-Ky.), and Ron Johnson (R-Wis.) released the following joint statement opposing the BCRA:[98]

Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor. There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.[10]

On March 9, 2017, Cruz criticized the AHCA, saying,[99]

I cannot vote for any bill that keeps premiums rising. ... My biggest concern with the House bill is it doesn’t lower premiums. And [the Congressional Budget Office] in fact projected that in the first two years premiums would rise 10 to 20 percent. ... I do not believe it will pass the Senate. ... I’ve got to tell you, if Republicans hold a big press conference and pat ourselves on the back that we’ve repealed Obamacare and everyone’s premiums keep going up, people will be ready to tar and feather us in the streets. And quite rightly.[10]

On March 8, 2017, Cruz said that Vice President Mike Pence should overrule the Senate's parliamentarian on what is allowed in a reconciliation bill so that the GOP could expand the scope of the AHCA. He said, “Under the Budget Act of 1974, which is what governs reconciliation, it is the presiding officer, the vice president of the United States, who rules on what’s permissible on reconciliation and what is not. That’s a conversation I’ve been having with a number of my colleagues."[100]

Cruz expressed support for the following:

  • A full repeal of the ACA;[50]
  • Eliminating guaranteed issue;[51]
  • Eliminating community rating[51]
  • Allowing insurers who offer at least one ACA plan to also offer cheaper plans that cover less; and[16]
  • Repealing all of the ACA's insurance regulations.[52]

Utah

Pending legislation Sen. Orrin Hatch

Hatch expressed support for the following:[101]

  • Preventing insurers from charging individuals with pre-existing conditions more for insurance or denying them coverage;
  • Covering individuals up to age 26;
  • "Special coverage for children with disabilities that have high medical costs;" and
  • "Increased state flexibility to care for people with mental health and substance use disorders."

Circle thumbs down.png Sen. Mike Lee

On July 17, 2017, Sen. Mike Lee (R-Utah) expressed opposition to the revised version of the BCRA in the following statement:

After conferring with trusted experts regarding the latest version of the Consumer Freedom Amendment, I have decided I cannot support the current version of the Better Care Reconciliation Act,” Sen. Lee said. “In addition to not repealing all of the Obamacare taxes, it doesn’t go far enough in lowering premiums for middle class families; nor does it create enough free space from the most costly Obamacare regulations.[102][10]

On June 22, 2017, Sens. Lee, Rand Paul (R-Ky.), Ted Cruz (R-Texas), and Ron Johnson (R-Wis.) released the following joint statement opposing the BCRA:[103]

Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor. There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.[10]

On March 7, 2017, Lee expressed opposition to the AHCA, saying,[104]

This is not the Obamacare repeal bill we’ve been waiting for. It is a missed opportunity and a step in the wrong direction. We promised the American people we would drain the swamp and end business as usual in Washington. This bill does not do that. We don’t know how many people would use this new tax credit, we don’t know how much it will cost, and we don’t know if this bill will make health care more affordable for Americans. This is exactly the type of back-room dealing and rushed process that we criticized Democrats for and it is not what we promised the American people. Let’s fulfill our Obamacare repeal promise immediately and then take our time and do reform right. Let’s pass the 2015 repeal bill that Republicans in both houses of Congress voted for and sent to the White House just 15 months ago. Once Obamacare has been properly sent to the dustbin of history then we can begin a deliberative, open, and honest process to reform our nation’s health care system.[10]

Lee expressed support for the following:

  • A full repeal of the ACA;[50]
  • Eliminating guaranteed issue;[51]
  • Eliminating community rating; and [51]
  • Repealing all of the ACA's insurance regulations.[52]

West Virginia

Pending legislation Sen. Shelley Moore Capito

On June 27, 2017, Sen. Shelley Moore Capito (R-W.Va.) expressed opposition to the BCRA in the following statement:[83]

I came to Washington to make the lives of West Virginians better. Throughout this debate, I have said that I will only support a bill that provides access to affordable health care coverage for West Virginians, including those on Medicaid and those struggling with drug addiction. In West Virginia, Obamacare has led to skyrocketing premiums, co-pays, and deductibles for families and small businesses. Patients have fewer choices in doctors and hospitals as networks shrink and plans become more restrictive. I have consistently looked for opportunities to improve this broken law, including co-sponsoring the Patient Freedom Act of 2017 earlier this year. I continue to believe we must repair what can be fixed, scrap what is not working, and create a better health care reality for West Virginians. At the same time, West Virginia has the largest Medicaid population in the country. I recognize that many West Virginians rely on health coverage and access to substance abuse treatment because of my state’s decision to expand coverage through Medicaid. I have studied the draft legislation and CBO analysis to understand its impact on West Virginians. As drafted, this bill will not ensure access to affordable health care in West Virginia, does not do enough to combat the opioid epidemic that is devastating my state, cuts traditional Medicaid too deeply, and harms rural health care providers. As drafted, the Senate health care bill is not the right fix for West Virginia, and I cannot support it. My concerns will need to be addressed going forward.[10]

On March 6, 2017, Capito and a group of senators wrote a letter to Senate Majority Leader Mitch McConnell (R-Ky.) stating that they would "not support a plan that does not include stability for Medicaid expansion populations or flexibility for states."[16]

Capito expressed support for the following:

  • A seven-year phaseout of Medicaid, instead of three;[52]
  • More generous tax credits to help low-income individuals and individuals in rural areas; and[52]
  • Increased funding for opioid addiction treatment.[85]

Wisconsin

Pending legislation Sen. Ron Johnson

On July 14, 2017, Sen. Ron Johnson (R-Wis.) said,

I am concerned about Leader McConnell's comments to apparently some of my Republican colleagues — 'Don't worry about some of the Medicaid reforms, those are scheduled so far in the future they'll never take effect.' I've got to confirm those comments ... I think those comments are going to really put the motion to proceed in jeopardy, whether it's on my part or others.[105][10]

On July 13, 2017, Johnson said that he would vote for a motion to begin debate on the BCRA, but he did not say if he would vote for the BCRA. Johnson said, "I want to work with the CBO to actually get better numbers and some breakout numbers as well. I think it informs the public better in terms of what our bill is."[106]

On June 28, 2017, Johnson said, “If we were to repeal all of the market reforms, utilize high-risk pools to make sure people with pre-existing conditions were covered, we could literally drive down the gross premiums for every American.”[52]

On June 26, 2017, Johnson criticized the BCRA in an op-ed. He wrote,[107]

The bill’s defenders will say it repeals Obamacare’s taxes and reduces Medicaid spending growth. That’s true. But it also boosts spending on subsidies, and it leaves in place the pre-existing-condition rules that drive up the cost of insurance for everyone. Instead, we should return more flexibility to states, to give individuals the freedom and choice to buy plans they want without Obamacare’s 'reforms.' And we should look to improve successful models for protecting individuals with pre-existing conditions, models underway prior to Obamacare, such as those in Maine and Wisconsin. Only then can the market begin to rein in the underlying cost of health care itself and reduce the cost of taxpayer subsidies. We are $20 trillion in debt. The Congressional Budget Office projects an additional $129 trillion of accumulated deficits over the next 30 years. A truly moral and compassionate society does not impoverish future generations to bestow benefits in the here and now. Republican leaders have told us the plan unveiled last week is a draft, open to discussion and improvement. I look forward to working with Senate leadership and the president to improve the bill so it addresses the plight of the forgotten men and women by returning freedom and choice to health care.[10]

On June 22, 2017, Sens. Johnson, Ted Cruz (R-Texas), Mike Lee (R-Utah), and Rand Paul (R-Ky.) released the following joint statement opposing the BCRA:[108]

Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor. There are provisions in this draft that represent an improvement to our current health care system, but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.[10]

Johnson expressed support for the following:[52]

  • Repealing all of the ACA's insurance regulations;
  • Using high-risk pools to protect individuals with pre-existing conditions;
  • Giving states more control of Medicaid and ending the Medicaid expansion allowed under the ACA.

Wyoming

Pending legislation Sen. John Barrasso

On June 22, 2017, Sen. John Barrasso (R-Wyo.) released the following statement on the BCRA:[109]

After seven years of disruption and disappointment, it’s urgent that we act now to replace Obamacare with a new law that finally puts patients first and begins to stabilize insurance markets that teeter on the verge of collapse. What we are proposing today steers health care sharply away from federal mandates, higher taxes and government control. Instead, our draft bill puts the focus on affordability, access to care with more choices, and safeguards Medicaid for the most vulnerable and needy. The bill is not perfect, and because of budget rules it doesn’t include every prescription I would have liked. What I do know is that our path is a vast improvement over Obamacare and will finally start to build a health care system that works for many more Americans. Over the next week, we will be working to improve on this draft with broad input from health care providers, patients, and every member of the U.S. Senate.[10]

Barasso expressed support for the following:[109]

  • Repealing ACA taxes; and
  • Repealing the individual and employer mandates.

Pending legislation Sen. Mike Enzi

Sen. Mike Enzi (R-Wyo.) released the following statement about the BCRA on June 22, 2017:

After months of hard work, Senate Republicans are proposing solutions to address the challenges to health care created by Obamacare that are affecting millions of hardworking families. Senate Democratic leaders have repeatedly declared they would not be part of getting rid of the current deficient system. Members of the GOP conference discussed many different options. The plan we’ve released today is focused on tackling the problem of skyrocketing premiums while stabilizing the collapsing Obamacare insurance markets that threaten to leave millions of Americans with no affordable options for health care. The discussion draft is also focused on fixing the challenges facing Medicaid while retaining our commitment to provide health care to our most vulnerable populations. Most importantly though, it repeals the individual and employer mandates freeing the American people from the requirement that forced families to purchase insurance they either did not want or could not afford. I look forward to working with my colleagues on both sides of the aisle to help the nation transition from Obamacare’s broken promises to better care.[110][10]

Enzi expressed support for the following:

  • Repealing the individual and employer mandates.[110]

See also

Footnotes

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