INCREASINGLY concerned about the plight of the 37 million uninsured Americans, the American Academy of Family Physicians (AAFP) calls for Congress to enact legislation greatly expanding access to health insurance coverage through a plan that builds on the current private and public sector programs. While acknowledging that the present system is imperfect, the AAFP believes that the immediate concern is to provide access to health care for the uninsured while, at the same time, working toward reform of the US health care system. The AAFP plan would require employers to offer coverage to full-time workers and their dependents, substantially revise and expand the Medicaid program, and include a Medicaid buy-in for those without employer-based insurance. The total increase over current spending to implement the AAFP proposal is estimated at $18.3 billion, exclusive of administrative costs. During the past 2 years the problem of the approximately 31 to 37 million Americans