As Republican legislators continue their efforts to repeal and replace the Affordable Care Act, they keep on looking for new ways to separate portions the insurance markets into different segments. These efforts run counter to some key actuarial and insurance principles: segmenting the risk pool increases volatility and that creation of different risk pools based on health status can lead to increased premiums for many.

Senate Republicans have released their revised proposal to repeal and replace the Affordable Care Act. The revised proposal makes a handful of significant changes to the Senate proposal released in June.

The Congressional proposals to replace the Affordable Care Act create winners and losers - and may reduce insurance premiums for some of these winners. But shifting costs around does not really reduce national health care costs. This represents a missed opportunity – there are things Congress could do to that might actually lower costs.

Senate Republicans have released their proposal to repeal and replace the Affordable Care Act. The bill, named “The Better Care Reconciliation Act,” repeals many provisions of the ACA - especially tax provisions contained in the ACA. The bill also makes significant changes to the non-tax provisions of the ACA. In addition to the changes actually contained in the bill, the BCRA delegates tremendous autonomy to the states to eliminate many other feature of the ACA.