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CAFP Strongly Opposes the Senate Health Care Overhaul Bill

U.S. Senate leadership recently released the Better Care Reconciliation Act (BCRA) to repeal and replace the Affordable Care Act (ACA). The Congressional Budget Office released its analysis of the bill this week, estimating that under the BCRA, 49 million people (nearly 20 percent of the U.S. population) would be uninsured in ten years, shattering previous historical rates of uninsured individuals and nearly doubling the current rate. If passed, the BCRA would represent the largest rollback of the social safety net in American history.


The evidence is clear: uninsured individuals are far more likely to postpone or forgo health care treatment, resulting in potentially severe health consequences and imposing enormous financial burdens on them, their families and society. The bill’s provisions would be particularly onerous for low-income individuals, the middle class, the elderly, the disabled and those with serious preexisting medical conditions. CAFP strongly opposes the bill for these reasons.


As an organization that represents family physicians across the political spectrum, it is important that our members know our position is not a matter of politics – it is a matter of policy. The BCRA fails on all five pillars of CAFP’s health care system reform policy, which stipulates that health care system reform must be:

    • Universal: provides insurance coverage to every person.
    • Comprehensive: provides insurance that includes a broad array of essential health services.
    • Timely: provides sufficient workforce and access to appropriate health care clinicians within reasonable time and distance standards.
    • High Quality: delivers health services according to medically- and culturally-determined standards of practice.
    • Sustainable: accounts for overall system financing, as well as the financial sustainability of family medicine practices.


    The following provisions of the bill stand in direct conflict with those principles:

      • Removes consumer protections that prohibit discrimination in insurance underwriting based on age, gender or health status.
      • Ends Medicaid coverage for millions of current patients and significantly cuts future federal funding, likely further reducing California’s already dismal Medi-Cal payments to clinicians.
      • Allows insurers to charge older customers five times more than younger ones for the same health plan.
      • Permits the elimination of minimum Essential Health Benefits, including reproductive health care services.
      • Authorizes insurance companies to charge deductibles that equal half the annual income of the poorest enrollees.
      • Abolishes the Prevention and Public Health Fund, which was designed to pay for preventive health services and address such public health threats as the Zika virus.


      California’s family physicians are on the front line of health care every day, providing care to millions of men, women and children in communities large and small, rural and urban, wealthy and poor. Family physicians save costs AND lives. Primary care must be the foundation on which any health care system is built. The BCRA would return the U.S. health care system to the days of expensive, inefficient care and reduce access for tens of millions. This bill should be defeated so a more thoughtful discussion can take place about how to decrease health costs without putting the health and well-being of millions of Americans at risk.

      CAFP asks that you please use AAFP’s Speak Out tool to urge legislators to oppose the BCRA.