The Senate just came out with a new version of its repeal and replace plan - here's what you need to know


U.S. Senator Rob Portman (R-OH) speaks during a session called

Thomson Reuters

Rob Portman speaks at the Wall Street Journal's CEO Council meeting in Washington


The Senate just introduced a new version of their plan to repeal and replace Obamacare.

The newest version of the Better Care Reconciliation Act - which Sen. Ron Wyden of Oregon nicknamed "Trumpcare 3.0" - reinserts an amendment that experts argue could have a big impact on people with pre-existing medical conditions.

This version of the bill would need 60 votes to pass.

The bill still provides that more funds will be set aside for the opioid crisis, and people will be able to pay for premiums using a health savings account. It also takes deep cuts to Medicaid.


Here's the quick summary of what's all in the new bill:

  • The Consumer Freedom Amendment, proposed by Senator Ted Cruz.
  • The Portman Amendment, which provides $100 billion in funding to stabilize states.
  • It also makes some changes to a section that would have made out-of-pocket maximums technically higher than what's allowed by the law.

The Portman Amendment

The bill includes an amendment from Sen. Rob Portman of Ohio, which sets up $100 billion in new funding to stabilize states. It does this by increasing funding from $19.2 billion a year to $30.2 billion. Portman has expressed concerns about the BCRA before for not providing enough funding for Medicaid tackling the opioid crisis.

The Consumer Freedom Amendment

Unlike the one scored last week by the Congressional Budget Office, this bill includes an amendment from Sen. Ted Cruz of Texas that critics said could make plans with adequate coverage unaffordable to those who have certain medical conditions.

The amendment would have allowed plans to exist that don't comply with two regulations set up under the Affordable Care Act, the law better known as Obamacare: community rating and essential health benefits. The latter could have had a big impact on people with preexisting conditions.

Under the Cruz amendment, titled the "Consumer Freedom Amendment," because some health plans wouldn't have to necessarily adhere to the community rating and essential health benefits. Those that do would receive$70 billion in funding to offset the higher premiums that would result relative to the plans that don't cover the regulations. Whether that funding would be enough to make the plans affordable remains to be seen. While the CBO analysis might have shed some light, the amendment was pulled from the draft bill.

On Wednesday, the Department of Health and Human Services released a report on the Consumer Freedom Amendment, taking a look at what it would do in the context of the ACA - not the BCRA bill. The report came to the conclusion that Cruz's amendment would lower premiums in both the traditional ACA plans and the less regulated ones.


That goes against what experts say about the amendment. They argue that it is likely premiums under both types of plans would likely rise if the amendment was put in place. The insurance industry's lobbying group said the amendment would lead to "widespread adverse selection and unstable health insurance markets."