Assessment Reflects Version of Bill without the Cruz Amendment, Softening Score of Proposal’s Devastating Impact on Coverage

RALEIGH (July 20, 2017) — Today the Congressional Budget Office (CBO) released its assessment of the latest version of the Better Care Reconciliation Act (BCRA). While the CBO’s findings confirm that this bill remains fundamentally unacceptable and would take coverage away from 22 million Americans, the version of the bill they reviewed was missing key provisions of the GOP Senate’s proposal.

In particular, this version of the BCRA does not include the controversial Cruz Amendment, which would reintroduce explicit discrimination against people with pre-existing conditions, as well as the sale of bare-bones plans featuring high deductibles of up to $12,000. However, this bill does include additional federal funding that a previous version used to mitigate the destabilizing effects of the Cruz Amendment. That the bill used by CBO today includes this funding—dollars earmarked to clean up the mess created by Cruz Amendment—without the Cruz Amendment itself suggests that this CBO score does not reflect the devastating impact of the final bill that the Senate may bring to a vote as soon as next week.

The Trump administration’s Department of Health and Human Services (HHS), which has actively and inappropriately advocated for repeal and replace of the Affordable Care Act, recently released its own rosy evaluation of the Cruz Amendment. That favorable report, however, contained major methodological flaws—too many to be coincidental—and did not disclose critical information about its assumptions.

Supporters of the BCRA may try to combine the findings of the HHS report with today’s CBO score to produce a more favorable reading, but these analyses are incompatible due to the flaws of the HHS report, and any such effort would be outright misleading. In light of the interested source of the report, misleading findings, and numerous flaws in its methodology, the nonpartisan and disinterested analysis of a third party like CBO is more critical than ever.

Here’s what CBO found about the latest version of the BCRA:

  • 22 million Americans would lose coverage;
  • Medicaid funding—which covers 1.4 million North Carolina children, as well as people with disabilities and seniors in long-term care—would be slashed by 26 percent over 10 years (and by even more beyond);
  • Average deductibles would reach $13,000, so high that “many people with low income would not purchase any plan even if it had very low premiums”;
  • Plans would cover fewer benefits and services, forcing people with pre-existing and chronic conditions to pay more or go without necessary care; and
  • Lifetime limits and annual caps on coverage would return.

FOR MORE INFORMATION, CONTACT: Brendan Riley,, 919.861.2074; Julia Hawes,, 919.863.2406.