Revised Senate healthcare bill includes version of Ted Cruz's controversial amendment

Senate Majority Leader Mitch McConnell
Senate Majority Leader Mitch McConnell is expected to officially release a revised Better Care Reconciliation Act later today. (Gage Skidmore/CC BY-SA 2.0)

Despite opposition from the health insurance industry, Senate Republicans’ revised healthcare bill includes a version of a proposal that would allow the sale of slimmed-down individual market plans.

A new discussion draft (PDF) of the Better Care Reconciliation Act includes a provision based on an amendment proposed by Sen. Ted Cruz, R-Texas. The provision would allow insurers to sell plans that don’t comply with the Affordable Care Act’s benefits requirements as long as they sell at least one plan in that state that does comply.

America’s Health Insurance Plans, which has largely avoided passing judgement on the GOP’s ACA repeal measures, said this week the Cruz amendment would “would create even greater instability” in the individual marketplaces. A separate report estimated that it could result in 1.5 million people with pre-existing conditions facing higher premiums.

Perhaps in a nod to these concerns, the Senate’s revised measure includes an additional $70 billion to help states lower insurance premiums. States with exceptionally high premiums would also get some assistance, as the Kaiser Family Foundation's Larry Levitt points out:

The reworked Senate bill also maintains the ACA’s taxes on wealthy individuals, and it adds $45 billion in funding to fight the opioid crisis.

Though the cuts to Medicaid that have concerned moderates are left largely intact in the revised bill, the new version does offer some Medicaid funding flexibility for states in the event of a public health crisis. States would also be able to add the newly eligible Medicaid population to coverage under the block grant funding option.

Editor's note: This article has been updated to reflect the fact that the revised bill was released.