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Senator Lankford Statement on Revised Senate Healthcare Bill

WASHINGTON, DC – Senator James Lankford (R-OK) made the following statement on today’s release of Senate Republican’s revised healthcare reform bill, the Better Care Reconciliation Act (BCRA), which intends to stablize healthcare markets, lower premiums, and give the states more control over healthcare regulation: 

“I believe we need healthcare reform that provides better healthcare choices and helps bring down costs for people in our state. I have started analyzing the revised draft bill to determine its benefits for Oklahomans. My goal is to vote on healthcare reform legislation that will be affordable and practical for Oklahomans of all socioeconomic levels and all health conditions. I will fight for a system that offers more choice, lower premiums, and a stronger, sustainable safety net for vulnerable Oklahomans.”

This Better Care Reconciliation Act is a budget reconciliation bill, which only requires simple majority (51 votes) in the Senate for passage, only one time per fiscal year. Created by the Congressional Budget Act of 1974, reconciliation allows for expedited consideration of certain tax, spending, and debt limit legislation. The Affordable Care Act was also a budget reconciliation bill, signed into law by President Obama on March 23, 2010. Because this is a reconciliation bill, only tax, spending, and debt limit issues can be reformed or repealed through this legislation.

The Better Care Reconciliation Act is only one step in a three step process to replace the Affordable Care Act and lower healthcare costs. Step two includes administrative actions, by the Department of Health and Human Services Secretary, that will make regulatory reforms to the health insurance market. Step three includes additional healthcare legislation that cannot be done through the reconciliation process. 


  • Lowers health insurance premiums by 30% by 2020, compared to Affordable Care Act projections.
  • Requires continued coverage for people with preexisting conditions.
  • Allows dependents to stay on their parents health policies until age 26.
  • Dedicates $132 billion, over 8 years, to encourage states to assist low-income individuals to purchase health insurance.
  • Impacts Members of Congress healthcare just like all Americans. (ie. Senator Lankford is currently on Obamacare)
  • Allows insurers to offer cheaper plans with less coverage options. 
  • Does not make any changes from current law to annual lifetime coverage limits.
  • Does not cut Medicaid from current funding. Under this bill, funding for Medicaid would continue to grow, yet not at the steep, beyond-inflation growth that is projected over the next 10 years. In fact, under the BCRA, spending on Medicaid in 2026 will increase to $466 billion, a 26 percent increase from now. 

NOTE: The news media continues to claim that this bill “cuts” Medicaid. This is not entirely true. The media makes this claims because under this bill, in 2021, there would be gradual reductions in the amount of federal Affordable Care Act funds provided to expand Medicaid, which would restore levels of federal support to preexisting law by 2024. So, Medicaid funding would still grow beyond 2021, but not at the same steep, rapid growth that it has been growing. The BCRA’s intent is to strengethn Medicaid to better care for the disabled, children, and the low-income, rather than able-bodied middle class working adults. This Medicaid reform has minimal impact for states like Oklahoma, because it never accepted Medicaid expansion. 

  • Provides state Governors with more flexibility in how their Medicaid system provides healthcare to those who are eligible.
  • Provides assistance for low-income Americans by offering health insurance subsidy assistance for Americans in the 0% to 350% federal poverty level range. This would also benefit the approximately 82,000 Oklahomans in the “coverage gap.” This tax subsidy will expand healthcare access and choice for low-income Americans, because they can transition from Medicaid to private insurance, with the help of tax subsides.  
  • Eliminates the individual and employer mandates penalties.
  • Makes no changes to Medicare (which is the primary source of health coverage for Americans 65 and older).
  • Protects against an “age tax” by limiting what older, middle-income Americans pay toward the purchase of health insurance, to ensure they have access to a plan that fits within their financial means.
  • Helps rural hopsitals by restoring Affordable Care Act cuts to Medicaid Disproportionate Share Hospitals (DSH), which helps non-expansion states pay hospitals an enhanced Medicaid payment to care for its safety net population.
  • Allows people to use their pre-tax Health Savings Accounts (HSAs) to pay for their health insurance premiums.
  • Creates a Medicaid special exemption for disabled children from the per capita caps, which guarantees children with medically complex disabilities will continue to be covered through Medicaid.
  • Will not include any changes from current law to the net investment income tax, the additional Medicare Health Insurance (HI) Tax, or the remuneration tax on executive compensation for certain health insurance executives.