This week, our In Focus section comes to us from HMA Senior Fellow Jack Meyer, PhD, and Senior Consultant Rachel Patterson, both of HMA’s Washington, DC office, with contributions from HMA colleagues Eileen Ellis, Melisa Byrd, Kathleen Nolan, Tim Beger, Aimee Lashbrook, and Barbara Smith. On June 22, Senate leadership released a discussion draft of the Better Care Reconciliation Act of 2017. The bill is technically an “amendment in the nature of a substitute” to HR 1628, meaning that it replaces wholesale the language from the House while continuing to use the same bill number, allowing the Senate to avoid the committee process and bring the reconciliation bill straight to the floor. The House’s AHCA had two major policy areas important to HMA and our clients: 1) treatment of the ACA’s Exchange markets, plans, benefits, and regulations, and 2) treatment of Medicaid in the per-capita-cap and expansion. The Senate’s BCRA includes private market provisions that more closely mirror the original ACA, but has much deeper Medicaid cuts and reforms than the House.