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BCRA: The Anti-Healthcare Bill

Audio Podcast (192kbps MP3 download)
(video at bottom of text)

Hello and welcome back to the ericvalor.org Blogcast Podcast.

My name is Eric Valor and I will be your host for this episode. Please make yourselves comfortable and feel free to order something from the bar.

As my longtime readers know, this is not a political blogcast. The scope of this blogcast is limited to the subject of ALS, living with the disease, research into treatments for ALS, experiences of Person(s) with ALS (PALS), and my personal reflections. I routinely deny requests to “guest blog” general health subjects (also because they are just attempts to spread spam links). But I have to address a subject which affects 17% of our entire economy and the daily lives of 99% of our citizens, and has devastating implications for PALS and others similarly affected by severe conditions. That subject is the long-awaited Republican response to the Patient Affordable Healthcare Act, also known as the Affordable Care Act or more colloquially Obamacare.

On Thursday, June 23rd, 2017, the Republican Senate Majority Leader released a “discussion draft” of their supposedly “better” healthcare plan which was promised to lower medical costs and improve medical care for American citizens, and “rescue” us all from the “disaster” of Obamacare. Just like the ridiculous House bill (which Paul Ryan apparently hurriedly cobbled together over a long weekend), the Senate Better Care Reconciliation Act snatches access to healthcare from, and makes it much more expensive for, tens of millions of Americans. We waited 7 years for this? I call it the anti-healthcare bill.

Republicans incessantly whined for 7 years about how terrible Obamacare was, how they had “a much better plan”, how the ACA was “passed in secret with no hearings, input from Republicans or the public, and was written behind closed doors. Actually it was available online for a year for public comment, had over 100 hearings, and included over 100 Republican amendments. After all that time this embarrassment on paper is the best they can come up with? This naked frontal assault on the poor and middle-class WILL LITERALLY KILL ME and others with ALS and other deadly conditions – all to give around $1 TRILLION to the already-hyper-wealthy. Moreover, it was literally written in complete secrecy behind closed doors (in such secrecy that one of the supposed authors of the bill never saw it until today) and will have no hearings with less than 10 hours of debate and amendments before a vote is called about a week from now. Undoubtedly Senator Tortoise McGee wants to rush this vote before senators go on recess and get an earful from constituents.

Article on the BCRA from The Guardian

Obamacare is NOT “failing” (as Republicans ludicrously tried to proclaim even before ACA went into effect). The reality of the situation is that tens of millions more Americans have access to affordable healthcare. Medical bills are the number 1 cause of bankruptcy in America. And that comes from a lack of insurance.

The ACA is only “failing” in those states which intentionally refused to cooperate with the Medicaid expansion where the federal government paid 100% of the costs for 3 years and thereafter covered 90%. These same states also refused to set up state exchanges, forcing residents onto the federal one. No wonder they have problems – and all just so Republican governors and legislatures wanted to score political points at the expense of their citizens. People may try to say this is just partisan finger-pointing but unfortunately for their view it’s also true. In the states which cooperated and implemented the provisions of the ACA it’s working out wonderfully.

The ACA in its final form was not designed to lower medical costs because that was negotiated out of the bill by Republicans and Pharma lobbyists. But it did, in fact, reduce the rate at which America’s healthcare expenditures increased, and it created significant affordable relief for tens of millions who would otherwise continue without care until forced to show up in the ER with a catastrophic condition. An ounce of prevention is worth a pound of cure.


All major medical organizations have released statements in complete opposition to BRCA. I would like to quote from the statement from NORD (National Organization for Rare Disorders):

“First, the BCRA will cut hundreds of billions of dollars of Federal funding from the Medicaid program by instituting per capita caps and optional block grants. Medicaid is a critical lifeline to millions of individuals with rare diseases across the United States. … State programs for Medicaid home and community-based services (HCBS) waivers (1915 waivers) may also be jeopardized due to financial constraints.

Second, the BCRA … would phase out Medicaid expansion starting in 2020 and concluding in 2024, likely leaving many individuals with rare diseases without health insurance.

Third, the BCRA does not adhere to several of our principles relating to prohibiting discrimination against individuals with pre-existing conditions. … [The BCRA] would still bring back annual and lifetime limits and limitless out-of-pocket costs by allowing states to amend the Essential Health Benefits (EHB) through section 1332 waivers. These vital protections … would therefore be removed if a state opts out via a 1332 waiver.

Finally, the BCRA does nothing to incentivize healthy individuals to enter the individual market and help stabilize premiums by offsetting the cost of more expensive individuals.”

NORD Statement

I would also like to quote Judith Stein, the Executive Director for the Center for Medicare Advocacy (CMA):

“Never in 40 years of Medicare & Health care advocacy have I witnessed the kind of secrecy, and determination to take away health coverage we are witnessing today. A health care bill would strengthen coverage and delivery programs. This bill gratuitously weakens Medicare, decimates Medicaid, and guts insurance for over 20 million people.”

According to CMA, the BCRA includes:

  • The end of Medicaid expansion: Millions will lose coverage.
  • Medicaid per capita caps: Cuts would actually deepen over time.
  • Repeal of Medicare tax increase: Undermines Medicare’s finances.

CMA Statement

This is a statement I added to a change.org petition calling for a “Medicare for All” program:

“I am currently living only because of Medicare and Medicaid. I have Lou Gehrig’s Disease, and used to be a top-10% wage earner. The disease forced me into bankruptcy slightly before I was even middle-aged. The United States is the wealthiest country in global history, and we have much more than enough taxation right now to pay for guaranteed healthcare. Medicare functions at a much higher efficiency than any other private for-profit insurance, because it doesn’t have a powerful incentive to maximize profit by denying me the services I paid for. Even with “Medicare for all” as a basic level of healthcare, there is still plenty of market left-over for private insurance for things like elective procedures.

It’s time for our public tax dollars to be applied toward services for the public, not for the enrichment of some private corporation. The last year has seen a massive awakening in public attention toward healthcare. If you are not aware of this by now, it’s because you are not paying attention to the voices of your constituents. But we are, and are very much aware of your actions (or lack thereof).”

Please consider signing the petition. It’s not likely to be successful by itself but it will show Congress that there is significant resistance to the GOP plan and that the right move is to actually expand Medicare in order to ensure the right of healthcare for all citizens.

Change.org Petition Link

The BCRA is a hideous piece of legislation that severely jeopardizes the poor, the elderly, and the handicapped like me. It’s basically a tax cut for the hyper-wealthy that is paid for by the suffering and death, yes death, of people coping with ALS and other deadly conditions that were stricken through no fault of their own. It’s a serious threat to my life and the lives of many of my friends. That required me to make this political statement.

Thank you for watching and please vote carefully and diligently in 2018. It can change lives in a major way. In the meantime, please contact your senators immediately and urge them to vote “No” on the BCRA. Until next time, keep breathing easy.

5 thoughts on “BCRA: The Anti-Healthcare Bill”

  1. Awesome article Eric! I signed the petition as well. I can’t even fathom what would happen if these awful bills pass.

  2. Wow! Total eye-opener Eric! Could you help explain the part how the BRCA will kill us PALS ,so they (pro -repeal people )don’t think it is just hyperbole? My wife & I took a huge hit both financially (her premiums almost tripled ) and medically. I have seen my Medicare services erode to minimal levels ever since the ACA kicked in 2013. We didn’t even dream it could get any worse !

    1. Happy to help. Let me start with your second question first. Medicare spending went down in 2013 thanks to the sequestration which was the result of the second time Republicans tried to shut down the government over the spending cap (which is a normal bill to cover spending which *already* happened – remember the first time resulted in downgrading America’s credit rating). Also, home health spending was sharply reduced. CBO predicts that spending in the next decade will increase from 3.2 to 3.9% of GDP. The ACA did not become effective until 2014.

      Now, for Medicade which is a different animal altogether. The BCRA drastically eliminates Medicaid spending which eliminates the services people like me depend on. In my case, and with others, it pays for the 24/7/365 caregivers required for life on a vent. With others, it would eliminate coverage for medication they otherwise cannot afford (very few people can afford the full cost of medicine). Medicaid is is the healthcare coverage for about 20% of the people in the US or around 62 million people. Without healthcare, many are at extreme risk. Assuming even 5% of that population dying from lack of access to medication or services is around 3.1 million people.

      That’s a massive number of folks who could otherwise not suffer if a huge tax break was not given to a very few who are are doing far better than the vast majority of fellow citizens. As I said in the blogcast, I was a top-10% wage earner. A few percent increase in my marginal tax rate would equal an amount of money I would not really miss at the end of the year, but if it meant guaranteed healthcare for me and my fellow citizens, it would be a great deal for me. It would be less expensive than my contributions to my top-tier employer-provided health insurance!

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