Comparing Key Provisions: Affordable Care Act, American Health Care Act, and Better Care Reconciliation Act

July 21, 2017

An image of the Capitol building, where the Better Care Reconciliation Act has been proposed.Editor’s Note: CHRT revised the following table (originally published June 27, 2017) to reflect both the U.S. Senate’s July 13 revision of its Better Care Reconciliation Act (BCRA) and the Congressional Budget Office’s score of the revised BCRA.  

On June 22, 2017, Senate Republicans released a discussion draft of the Better Care Reconciliation Act, their proposal to repeal and replace the Affordable Care Act (ACA). The Senate draft retains a similar overall structure as the American Health Care Act, which passed the U.S. House of Representatives in May 2017, but includes some notable differences. The following table compares key provisions of the ACA, American Health Care Act, and Better Care Reconciliation Act. It compares them across several categories: Ensuring Continuous Coverage, Tax Credits for Individual Market Coverage, Cost-Sharing Reductions, Medicaid Expansion, Medicaid Funding Structure, Health Savings Accounts, Private Insurance Market Regulations, Market Stability and Risk Pool, Taxes and Fees, Impacts on Coverage and Premiums, and Impacts on Federal Budget.

For example, for the category of Ensuring Continuous Coverage, the ACA requires an individual with a lapse in coverage to pay an individual mandate penalty of $695 or 2.5% of income above $10,000. The American Health Care Act repeals the ACA’s individual mandate penalty and instead requires individuals with a lapse in coverage to pay 30% higher premiums for one year upon re-enrolling in individual coverage. The Better Care Reconciliation Act also repeals the ACA’s individual mandate penalty, and subjects individuals with a lapse in coverage to a six-month waiting period before re-enrolling.

This document reflects the revised Better Care Reconciliation Act as of July 13, 2017. CHRT will update this table if the Senate votes to approve the motion to proceed.