Take Action against the Better Care Reconciliation Act

This week, the United States Senate will consider the Better Care Reconciliation Act – legislation that would repeal major portions of current law established through the enactment of the Patient Protection and Affordable Care Act in 2010.  This email is designed to give you an update on the process, the politics, and the advocacy activities the AAFP (American Academy of Family Physicians) will be executing in the next 3 to 4 days.

 As we enter the home stretch, we are shifting most advocacy activities to Twitter and phone calls.  We appreciate all you have done to mobilize your members against this legislation and we are asking you to make one more push this week.  Phone calls on Tuesdayand Wednesday will have the most impact.

The Senate switchboard number is (202) 224-3121.  The message is simple – vote no on the Better Care Reconciliation Act.


Republicans do not have 50 confirmed votes.  The whipping effort will shift into high-gear following the release of the CBO score.

Current “no” votes are: Dean Heller (NV), Rand Paul (KY), Ted Cruz (TX), Mike Lee (ID), Ron Johnson (WI)

Senators on our target list are: Susan Collins (ME), Dean Heller (NV), Lisa Murkowski (AK), Shelly Moore Capito (WV), Rob Portman (OH), Tom Cotton (AR), Mike Rounds (SD), Johnny Isakson (GA)


The Congressional Budget Office (CBO) will release their analysis of the Better Care Reconciliation Act on Monday, June 26 or Tuesday, June 27.

The Senate must wait 28 hours after the release of the CBO score before they proceed to the legislation.

Senate Majority Leader will file a motion to proceed to the health care legislation

Reconciliation rules limit debate to 20 hours

Republicans likely will give back their 10 hours – meaning debate time will be 10 hours

Following the allotted debate time, the Senate will proceed to the “vote-a-rama” where Senators can offer an unlimited number of amendments

The final amendment will be the McConnell Substitute, which will be the Better Care Reconciliation Act

The McConnell amendment will replace the underlying legislation and any amendments that were adopted during the vote-a-rama

The McConnell substitute requires 51 votes to pass

Vote on the Budget Point of Order

Vote on final passage

If the CBO score is released on Monday, the vote on final passage will take place mid-day Thursday.  If the CBO score is released on Tuesday, the vote on final passage likely shifts to later in the evening on Thursday (or well into the night)

House consideration

It is possible the House will take up the BCRA (if approved by the Senate) on Friday or Saturday.

Advocacy Activities

The AAFP will send a whip letter urging a no vote on Wednesday or Thursday.

On Wednesday, June 28 the Group of 6 will release a letter of opposition, urging Senators to oppose the BCRA.

Physician leaders from the Group of 6 organizations will also engage in a series of meeting with key Senators and Senate Leadership.

AAFP President-elect Mike Munger, MD will represent the AAFP in these meetings

The Group of 6 also will hold a series of press conferences and media events on Wednesday, June 28.

·You can follow Group of 6 activities at the hashtag #docs4coverage.


·         AAFP Statement on the Better Care Reconciliation Act

·         AAFP Letter to the United States Senate on Better Care Reconciliation Act

·         Group of 6 Statement on the Better Care Reconciliation Act

·         Group of 6 Letter to Senate Leadership

·         Politico Summary of the Better Care Reconciliation Act

·         Vox Summary of the Better Care Reconciliation Act

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