The Better Care Reconciliation Act of 2017 will result in much worse, not better, health care for Americans. In its current form, over time the bill will devastate Medicaid, reducing or denying health care to millions of poor and elderly, and will leave states with unsustainable costs passed along by the federal government. States also would be permitted to change or determine what qualifies as an essential health benefit, which would be life-threatening to many patients and create confusion and inequality throughout the health care system. Since it does not include a requirement or any incentives for healthy Americans to buy health insurance, it will result in higher premiums and co-pays for many Americans. The legislation will unleash a slowly unwinding health care catastrophe.