Medicaid Changes in Better Care Reconciliation Act (BCRA) Go Beyond ACA Repeal and Replace

Issue Brief

1. The BCRA would exempt spending on children who are eligible based on a disability. However, most Medicaid children with special health care needs are eligible based on low family income and not based on a disability. For example, 82% of Medicaid children with special health care needs do not receive SSI.

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2. Under current regulations, provider taxes must be broad-based, uniformly imposed, and cannot hold providers harmless from the burden of the tax (i.e., providers cannot be guaranteed that their tax payment will be paid back). Federal regulations create a safe harbor from the hold-harmless test for taxes where collections are 6% or less of net patient revenues.

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3. Research shows that nearly 8 in 10 adult Medicaid enrollees live in working families, and a majority are working themselves. Among the adult Medicaid enrollees who are not working, most report major impediments in their ability to work.

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4. Except to save the life of the woman, or if the pregnancy arises from incest or rape.

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