Senate Republicans on Thursday released their response to the House-passed American Health Care Act, with a bill dubbed the Better Care Reconciliation Act of 2017. The bill mirrors much of the House legislation, including the repeal of the current individual mandate and sharp cuts to the Medicaid program.

In early May, House Republicans narrowly passed the controversial American Health Care Act, punting health reform to their Senate colleagues. But in late May, the nonpartisan Congressional Budget Office issued an analysis that found the House bill would leave 23 million people currently covered under the Affordable Care Act without health insurance.

Under the House bill, states would be permitted to waive health status rating protections and allow underwriting for some consumers – provisions which are also present in the Senate draft. Weakening these rules could enable insurers to charge patients with pre-existing conditions, such as heart disease and stroke, higher prices for the same services.

While the Senate bill would drop the waivers allowing states to bump up premiums on patients with pre-existing conditions, it would still allow states to assume waivers that ignore some coverage standards required by insurers under the Affordable Care Act, such as essential health benefits that include preventive and wellness services, chronic disease management and rehabilitative care.

The bill would allow insurers to charge older consumers five times more than younger patients for the same health coverage.

In addition, the Senate bill, like the House bill, would shift billions of dollars in health care costs to the states by phasing out distribution of federal government funds provided to the states to expand their Medicaid programs. Although the Senate bill would take away funding more gradually than the House proposal, the longer-term impacts would be deeper and more severe. With such drastic cuts to Medicaid, it is unlikely that states would be able to meet their increased financial obligations.

The Senate bill would also continue to fund cost-sharing reduction payments for two years that are intended to help stabilize the individual market. Businesses with 50 or more employees will no longer be required to provide health insurance for their workers. In addition, the bill would eliminate taxes on higher-income Americans and pharmaceutical and insurance companies that were intended to help pay for the law.

Before the bill’s release, President Trump said he hoped it would have more “heart” than the House legislation. But AHA CEO Nancy Brown called the Senate bill “heartless.”

“If passed it would erode the very patient protections and coverage Americans need the most,” Brown said in a statement. “Despite its name, this isn’t better care.”