Time

By: Alicia Adamczyk, Elizabeth O’Brien

The Senate on Thursday finally unveiled draft language for the Better Care Reconciliation Act, its replacement for the 2010 Affordable Care Act. Like its predecessor, the House’s American Health Care Act, the proposal would jeopardize coverage for lower-income and middle-class Americans in order to deliver big tax breaks for the wealthy.

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Critics slammed the Senate’s efforts. “Their driving strategy here isn’t good health care policy, it’s getting 50 votes,” says Joan Alker, executive director of the Georgetown Center for Children and Families. Senate Majority Leader Mitch McConnell has said he wants to bring a bill before the full Senate for a vote next week, and Republicans need 50 votes for it to pass, with Vice President Mike Pence casting the tie-breaking 51st vote.

It’s unclear exactly how much Medicaid funding would be cut under the Senate bill, since it hasn’t been scored yet by the CBO. Yet the House version cut nearly $840 billion in federal Medicaid funding through 2026, according to CBO estimates, and the Senate version is “harsher” than the House version, Alker says. The draft would switch Medicaid from an uncapped program that can increase funding to pay for both crises like the opioid addiction epidemic and new drugs and treatments, to a capped program. What’s more, starting in 2025, Medicaid spending would only be allowed to rise at the rate of general inflation, a rate much lower than needed to keep pace with rising health care costs, experts say.

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