June 27, 2017
2 min read

Armed with CBO report, AAFP sharply critical of Senate health care bill

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AAFP has unleashed a new round of criticism in the wake of the Congressional Budget Office releasing an analysis of the Senate health care bill known as the Better Care Reconciliation Act.

The Congressional Budget Office (CBO) report, released yesterday, states that although the proposed Senate legislation would reduce the cumulative federal deficit by $321 billion by 2026, it would increase the number of people who are uninsured by 22 million in 2026, meaning that an estimated 49 million people would be uninsured that year.

In addition, the report states that the average premiums for benchmark plans for individuals would be approximately 20% higher in 2018 than they would be under current law and in 2020, the premium for a silver plan would be a “relatively high percentage of income for low-income people.” Previous HHS reports indicate the second-lowest cost silver plan is significant because it provides the benchmark by which tax credits are calculated. Also, the report states that the benchmark plans under the Senate legislation would have high deductibles similar to those for the bronze plans offered under current law.

AAFP president John J. Meigs, Jr., MD, used the report as a springboard for his argument that the Senate version of the health care bill is not a good plan for Americans.

“The [Better Care Reconciliation Act] will not make insurance more affordable. It will not preserve meaningful benefits that cover basic, essential services needed by all Americans, especially those who have pre-existing conditions,” he said in a statement.

Meigs said the premium and deductible increases, as well as the option for states to stop providing essential services, as proposed in the Senate health care bill, are concerning as well.

“Premiums and deductibles for older Americans will skyrocket. Escalating copayments and deductibles will make access to actual health services financially prohibitive for Americans of all ages. Tax credits provide far less support, putting premium, copayment and deductible costs beyond the financial reach of millions of Americans. Without benefits such as prescriptions, laboratory services and outpatient care, patients have no actual access to the monitoring and preventive care they need to avoid complications,” he stated.

Even before the CBO report came out, AMA was largely critical of the Better Care Reconciliation Act, citing concerns about health insurance access and coverage; that Medicaid, CHIP and other similar “safety net” programs be adequately funded; and that key market reforms, such as pre-existing conditions, be maintained.


AMA also released a poll that indicates many components of proposed health care legislation — particularly Medicaid cuts and narrowed coverage plans — are largely unpopular among voters across most of the country. The survey was conducted before the Senate version of the health care bill was introduced.

Meigs reiterated the AAFP’s hopes for health care moving forward.

“The U.S. Senate must act, at minimum, to preserve the coverage gains achieved under current law and not take regressive actions that will harm millions of Americans.” – by Janel Miller

Disclosures: Meigs is president of AAFP.


Congressional Budget Office Document on H.R. 1628, Better Care Reconciliation Act of 2017 (accessed 06-27-17)

Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace (accessed 06-27-17)