Both BCRA and AHCA would allow states to receive Medicaid funds in the form of a block grant- this would enable states to construct their programs and funding to fit the needs and priorities of their residents, rather than be subject to inflexible federal rules that may make no sense across different contexts.

Sounds good, right? Not so fast. On the Health Affairs blog, Prof. Marianne Bitler and I argue that the history of welfare reform shows it may not be that easy.

How many acronyms were up there? (A few) Senate Republicans released their draft response to the House American Health Care Act, the Better Care Reconciliation Act.  There is much more detail in BCRA, and yet the upshot seems to be that BCRA ups the ante from the AHCA on disparities, again favoring the younger, healthier and wealthier vs. the poorer, sicker, and older.

Others have written excellent summaries of the BCRA overall, as well as specific review of changes to Medicaid not related to caps,  So I won’t waste your time or mine.

A couple points-

1. Immigrants: There’s a small distinction which appears to restrict premium tax credits from a subset of immigrants, all of whom are Lawfully Present (allowed to stay in US)  but now limited to Qualified Aliens vs. Non-Qualified Aliens.  As a non-expert, Non-qualified is utterly confusing to me and all I have figured out so far is that those under DACA are Non-Qualified and therefore would not be eligible for tax credits to purchase health insurance.
2. Elimination of the ACA Public Health and Prevention Fund: once again signaling how the U.S. simply does not prioritize public health.
3. Tax cuts for the wealthy: Income inequality goes up–> Health disparities go up.