Access to healthcare saves lives, prevents financial ruin, and simply makes life better. I am proud that advocating for affordable coverage was a focus of my earlier career. Alongside many tireless advocates, I worked for years to expand Medicaid — closing the coverage gap for Idahoans whose wages were too low to qualify for health insurance tax credits and too high for Medicaid. Republican obstructionism in the Idaho Legislature made it a lot harder than it should have been to champion a policy that’s extremely popular among Idaho voters. The scariest setback, however, came from Congress.

In 2017, Republicans took control of both chambers in Congress and the White House. As they seized power, repealing the Affordable Care Act was their top priority. Frighteningly, they had no replacement plan to prevent millions of Americans from losing coverage. As advocates in Idaho, we had to pause our work to expand healthcare access and try to block this serious attempt to take healthcare away. Months of nerve wracking negotiations culminated in Senator John McCain’s iconic and dramatic thumbs-down vote on the Senate floor. Fortunately, McCain joined two Republican U.S. Senators and every single Democrat to kill the repeal effort.

Recalling this barely averted disaster makes it all the more startling to hear every Republican presidential candidate vow to repeal the ACA. Again, they have no coherent replacement.

The renewed threat to working families and small business owners is staggering. ACA repeal would mean protections for up to 259,000 Idahoans with preexisting conditions would vanish, allowing insurance companies to deny coverage or hike costs for people with previous cancer diagnoses, high blood pressure, asthma, and other conditions. Medicaid expansion, which finally passed by a decisive majority of Idaho voters through an initiative, would end. Tax credits to purchase coverage, which assist 80% of individuals on the market, would disappear. Young adults would no longer be able to stay on their parents’ insurance. Insurance companies could again impose lifetime caps on coverage.

Idahoans are already losing healthcare access, thanks to Republican politicians. From passing one of the most extreme abortion bans in the country to criminalizing doctors and nurses, Republican politicians continue attacking our freedoms and making Idaho a hostile place for providers. Idaho ranks last in the nation for physicians and hospital beds per capita and more than 70% of Idahoans live in mental health shortage areas. This year, rural hospitals in Sandpoint and Emmett announced they can no longer provide labor and delivery services. More than 9,000 healthcare jobs in Idaho remain unfilled, according to Idaho Business for Education.

The ACA is a lifeline for Idahoans. Democrats will continue protecting the healthcare that is essential to the wellbeing of our families.