S Amdt 270 - Better Care Reconciliation Act of 2017 - National Key Vote

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Title: Better Care Reconciliation Act of 2017

Vote Smart's Synopsis:

Vote to pass an amendment that replaces the American Health Care Act with the Better Care Reconciliation Act, commonly known as the "repeal and replace" option.


  • Prohibits federal funds considered to be direct spending on state programs for any prohibited entity for a period of 1 year, effective on the enactment date of this act (Title I, Sec. 123).
  • Defines “prohibited entity” as an organization that is tax exempt by the International Revenue Code of 1986 and is an essential community provider, primarily engaged in (Title I, Sec. 123):

    • Family planning services;

    • Reproductive health;

    • Related medical care; and

    • Provides for abortions.

  • Specifies that abortion providers are exempt from the aforementioned policy if (Title I, Sec. 123):

    • The pregnancy is the result of rape or incest; or

    • The pregnancy will result in physical harm or injury to the mother of which could result in death.

  • Appropriates $15 billion for the 2018 and 2019 calendar years and $10 billion for 2020 and 2021 to the Administrator of the Centers for Medicare and Medicaid services to fund arrangements with health insurance issuers to assist in the purchase of health benefits coverage (Title I, Sec. 106).

  • Appropriates an additional $10 billion for calendar years 2020 through 2026 for the purpose of funding arrangements with health insurance issuers to support offering of qualified health plans in states which offer coverage for high risk individuals (Title I, Sec. 106).

  • Defines “qualified health plan” as a health care plan that does not include coverage for abortion unless (Title I, Sec 103):

    • Abortion is necessary to save the life of the mother; or

    • Pregnancy is the result of an act of rape or incest.

  • Authorizes that the administrator can withhold payment of funds if determined that the state is not using funds in a manner consistent with the description provided by the state in its application (Title I, Sec. 106).

  • Amends Medicaid to include individuals under 65 years of age, individuals who are not pregnant, and individuals whose income is below 133 percent of the poverty line (Title I, Sec. 125).

  • Specifies that the state may redetermine an individual’s eligibility every 6 months (Title I, Sec. 129).

  • Decreases the tax rates for providers (Title I, Sec. 131).

  • Specifies that the annual allotment to eligible states may not exceed $8 billion for each year listed under this act (Title I, Sec. 132).

  • Defines “eligible state” as a state that (Title I, Sec. 132):

    • Is one of the 50 states or District of Columbia;

    • Has a waiver or state plan amendment; and

    • Is selected by the secretary to participate in the demonstration project.

  • Authorizes the Secretary to withhold, reduce, or recover previous payments to a State found not to be in compliance with this act (Title I, Sec. 133).

  • Establishes a single state agency responsible for administering and implementing the Medicaid Flexibility Program (Title I, Sec. 133).

  • Specifies that a state conducting a Medicaid Flexibility Program shall provide the following services including, but not limited to (Title I, 133):

    • Inpatient and outpatient hospital services;

    • Physician, Laboratory, and X-Ray services;

    • Nursing facility services for individuals 21 and older;

    • Mental health and substance abuse services;

    • Rural health care services; and

    • Family planning services and supplies.

  • Authorizes a state to provide cost-sharing assistance for an eligible low-income individual who is enrolled in a qualified health plan if the state meets the requirements of this act (Title I, Sec 139).

  • Defines “eligible low-income individual” as an individual whose income does not exceed 133 percent of the poverty line and who is eligible for premium assistance for the purpose of a qualified health care plan (Title I, Sec 137).

  • Appropriates $4.97 billion for each fiscal year 2018 through 2026 to the Secretary of Health and Human Services to provide grants to states in order to fund substance use disorder treatment and recovery support services for individuals who have mental or substance use disorders (Title II, Sec. 202).

  • Authorizes health insurance issuers to impose a 6 month waiting period on any individual that cannot demonstrate the ability to hold continuous creditable coverage, and requires certificates proving creditable coverage (Title I, Sec. 206).

  • Specifies the repeal of the cost-sharing subsidy program beginning December 31, 2019 (Title I, Sec. 211).