The Atlantic

The Cruz Plan Would Splinter Health Insurance Markets

The Better Care Reconciliation Act already increases the risk of death spirals. Under new proposed additions, that risk becomes a near-certainty.
Source: Pablo Martinez Monsivais / AP

It’s way down there, at the bottom of the new bill, in brackets. The largest addition to the new draft of the Republican Better Care Reconciliation Act, released by Senate Majority Leader Mitch McConnell Thursday, is stashed away at the end of a 172-page series of amendments, Social Security Act references, and bits of tax code. The brackets around it indicate it’s not even fully part of the draft. But that new piece of language, based on language from Senator Ted Cruz, is a much more radical policy change than any of the other changes to private insurance in the bill.

The proposed amendment would create a two-tiered system in the exchanges, and would likely leave sicker people paying higher premiums. It would do that with a provision that would allow

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