Health Care Reform Update

The Senate’s Better Care Reconciliation Act (BCRA) does not appear to be moving forward. As of last night, four Republican senators - Mike Lee (Utah), Jerry Moran (Kansas), Rand Paul (Kentucky) and Susan Collins (Maine) - publicly stated they would oppose the revised version of the BCRA, leaving the bill short of the 50 votes required to proceed.

As a result, Majority Leader Mitch McConnell pivoted to a strategy of moving just a repeal bill using the text from a 2015 repeal bill that passed the House and Senate (and was vetoed by then President Obama). ( However, at least three Republican Senators – Susan Collins (Maine), Shelley Moore Capito (West Virginia), and Lisa Murkowski (Alaska) -  have stated they would not vote to move forward debate on a repeal bill without a replacement. Though the measure will not pass without these three Senators' support, Majority Leader Mitch McConnell says he will still move forward with the vote.

NRHA did not support the BCRA, which would have hurt vulnerable populations in rural Americans, leaving millions of the sickest, most underserved populations in our nation without coverage, and further escalating the rural hospital closure crisis.

To be clear, many provisions in the Affordable Care Act failed rural America. The lack of plan competition in rural markets, exorbitant premiums, deductibles and co-pays, the co-op collapses, lack of Medicaid expansion, and devastating Medicare cuts to rural providers – all collided to create a health care crisis in rural America. However, repealing the ACA which will not fix these problems and will create new health care challenges is not the solution.

Congress is listening to the rural voice. Your calls and comments have been heard and are making a difference on Capitol Hill. Tell Congress to protect rural patients’ access to care.

NRHA will continue to monitor health care reform and will provide updates as more becomes known.



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  • 4/22/2019 12:08:03 PM

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