The Senate released draft legislative text of its health care overhaul bill June 22. To add yet another acronym to the healthcare reform saga, they are calling their bill, the Better Care Reconciliation Act (BCRA). It builds off the version the House passed on May 4, called the American Health Care Act (AHCA), which was originally intended to repeal and replace the Affordable Care Act, or ACA.
Senate Majority Leader Mitch McConnell (R-Ky.) is now working to bring together different factions in the Senate to reach the critical 50-vote threshold to pass the bill. Some Republican senators — Rand Paul of Kentucky, Mike Lee of Utah, Ron Johnson of Wisconsin and Ted Cruz of Texas — released a joint statement saying they could not vote for the bill as presently drafted, though Leader McConnell will work vigorously to sway their votes over the next week.
It is not just conservative Republican senators he will have to appease, either. Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) have previously expressed concerns with how the bill’s cuts to Medicaid would impact hospitals, low-income individuals and people with disabilities. Other issues, including federal funding for Planned Parenthood and the ongoing opioid epidemic, have been raised by Republican senators.
McConnell must ensure no more than two Republicans vote “no” on the bill to achieve a simple majority under the special legislative procedure known as “budget reconciliation,” which health reform is being considered. He hopes to call a vote on the Senate floor this week before both chambers leave town for the July 4 recess.
Like in the House, a vote will likely only occur once Republicans are certain they have the support necessary for passage. If the Senate is successful in passing this legislation, its bill would have to go back to the House for approval before being sent to the president.
Senators return for three weeks in July and may make further attempts to pass a bill if they are unsuccessful this week. However, they want to avoid extending the issue beyond the long August recess. Congress and the administration are eager to move on to other legislative priorities such as tax reform and infrastructure, and there are other pieces of health legislation that Congress must consider before the end of the fiscal year, in addition to funding the federal government.