The Senate’s effort at writing a replacement bill for the Affordable Care Act is being assailed from all sides. Even some Republicans are coming out against the Better Care Reconciliation Act, saying it goes too far and or doesn’t go far enough.

With the BCRA now public, a report published in the journal Annals of Internal Medicine explores the influence health insurance can have on mortality.

According to Modern Healthcare, Dr. Steffie Woolhandler, coauthor of the study and a professor of public health at the City University of New York at Hunter College says, “It’s very important for the voters to know taking insurance from millions of people will result in increased death rates.”

The BCRA has been estimated by the Congressional Budget Office to cost 22 million people their health insurance coverage by 2026.

Woolhandler and her coauthor summarized the findings of multiple studies which compared mortality rates among uninsured and insured people. A number of studies over several decades have examined the disparity between insured and uninsured mortality rates, with most concluding the uninsured have higher mortality rates than the insured.

Two studies in particular reviewed by the researchers focused on mortality rates in Maine, New York, and Arizona during the early 2000s shortly after Medicaid eligibility was expanded.

They found a drop of approximately 6.1 percent in those states’ mortality rates, compared with neighboring states, in correlation to a 3.2 percentage-point decline in the uninsured rate. The biggest drops in mortality were among minority populations in low-income counties.

In addition, editors of the New England Journal of Medicine criticized the proposed legislation, saying while it may be called the “Better Care Reconciliation Act,” that’s not what it is at all.

NBC reports the journal has joined groups which represent doctors and other health care professionals to criticize the bill. “The U.S. Better Care Reconciliation Act…is not designed to lead to better care for Americans,” it quotes Dr. Jeffrey Drazen, the editor-and-chief of the medical journal, writing in the publication.

The editors write in the journal, “Like the House bill that was passed in early May, the American Health Care Act (AHCA) would actually do the opposite: reduce the number of people with health insurance by 22 million, raise insurance costs for millions more, and give states the option to allow insurers to omit coverage for many critical health services.”

“What would get ‘better’ under the BCRA is the tax bill faced by wealthy individuals, which would be reduced by hundreds of billions of dollars over the next decade.”

When it comes to taxes and the BCRA, the New York Times says a Republican senator who is backing the bill does not think Trump clearly understands the plan.

The article goes on, saying the senator felt Trump “seemed especially confused” when a moderate Republican pointed out opponents of the bill would characterize it as a “massive tax break for the wealthy.”

According to the Times report, Trump ignored the tax implications of the BCRA and commented he would tackle tax reform later.

Trump responded via Twitter, saying, “Some of the Fake News Media likes to say that I am not totally engaged in healthcare. Wrong, I know the subject well & want victory for U.S.”

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