The Better Care Reconciliation Act (BCRA)

By: Lori Hartwell

Update: July 17, 2017

New Senate Health Care Bill Revisions still allows states to opt out of key parts of AHA, meaning higher costs for people with pre-existing conditions such as kidney disease. In addition, Ted Cruz’s provision would allow insurance companies to offer bare-bones insurance plans alongside Obamacare-compliant plans that would be more expensive, but that would also provide comprehensive coverage.

The original bill passed the house in May and the senate is preparing to vote. A delay in the vote after the the 4th of July recess means we have a chance to connect with senators to urge them to vote no on this bill.

Contact your senators and let them know your concerns about this bill. Facebook’s “Town Hall” is another good place to connect with senators. 



 June 17, 2017

The Better Care Reconciliation Act (BCRA) will allow states to make drastic changes to market insurance rules.   This will allow insurers to offer minimal plans that don’t come with a basic set of “essential benefits.” This can result in excluding treatments and medicines for people with high-cost illnesses.

Without a mandate to insurers to include all essential health benefits and allowing insurers to write different policies will result in patients having more out-of-pocket costs for coverage that could be cost prohibitive too for many, especially people who have a pre-existing condition.




Under the existing Affordable Care Act, a number of services must be covered, which are referred to as “Essential Health Benefits,” which include:

Outpatient care (dialysis)

Emergency room visit and ambulance trips

In-hospital care

Pregnancy, maternity and newborn care

Mental health and substance abuse disorder services

Prescription drugs

Rehabilitative services and habilitative services

Lab tests

Preventive services

Pediatric services to include dental and vision care for children

(The proposed Plan will allow states to figure out which essential health benefits may or may not be included. You may be able to get a cheaper policy, but make sure you read the fine print to see what benefits you need.  

The Senate bill will undo the Affordable Care Act’s Medicaid expansion and cap the amount per person or per state. States decide which essential health benefits they will cover.     

This bill repeals many of the taxes put in place to finance the Affordable Care Act, such as taxes on the health insurance industry, the medical device industry and a tax on investment income.


You can help make a difference. Call, email, tweet or knock at their door! Contact Your Legislator and tell them/ask them to:


  • It is important that any new legislation protects people with pre-existing conditions so they will continue to have access to affordable care.

  • Keep the Medicaid expansion in place. (This was mentioned above and expansion is not required of the states currently.

  • Do not allow states to eliminate life-saving benefits currently provided under the Affordable Care Act.

  • Do not give insurers the right to discriminate against people with pre-existing conditions by excluding coverage for prescription medications and treatments.

  • Preserve existing financing for the current system to maintain the quality of health insurance provided to Americans with below-average incomes or pre-existing conditions.


Contact your legislators today!



Visit Home Dialysis Central for details of the bill and how will change existing law.