Thirty-one years ago when I was 26 years old with two young toddlers and an infant, freshly divorced and removed from my ex-husband’s job-related health care insurance, my doctor told me that a PAP smear indicated pre-cancer cells. He offered me a deal: Pay $500, and he’d treat the offending cells. All I had to do was scare up the cash —a small fortune for a newly-minted single parent. When I mentioned this to my brother, a physician, he was incredulous. Who would pay the hospital costs? The cost of medicines? Or the other fees he listed that I had no idea about?

Although I never returned to that doctor with $500 cash in hand, I did get the needed treatment, thanks to my brother’s colleague and professional courtesy. I’m lucky and grateful, considering the alternative.

The lack of health insurance can mean the difference between life and death — a lesson then hammered home for me, despite remaining uninsured for several years until landing a job offering health benefits. It’s a lesson more are beginning to appreciate now that the Affordable Care Act (ACA) — popularly known as Obamacare — is in jeopardy.

Public outcry against the planned repeal of ACA, coupled with the political ramifications of doing so without a replacement, has led Republicans to shift their vocabulary regarding Obamacare, but their actions are clear. They’re now using "repair" and "rebuild" as synonyms for "repeal," saying there’s been a misinterpretation or miscommunication of what they mean. We know better, considering they unsuccessfully voted more than 60 times to repeal the ACA, strictly for political reasons.

And last month, House Republicans passed a measure starting the process of dismantling the ACA, and on the heels of that, President Donald Trump wasted no time issuing an executive order to abolish it, delivering a death sentence to millions of Americans, especially those with pre-existing conditions. The Congressional Budget Office reports that in the first year of a repeal, more than 18 million Americans will lack health insurance, and a repeal adds trillions to the deficit. Since its inception, more than 20 million Americans have gained health care coverage, bringing the nation’s uninsured rate to the lowest levels in history and the rise of health care costs to their slowest rates in the last 50 years.

The American Medical Association and the American Hospital Association forewarn that a repeal will throw our entire health care system in turmoil. In short, more than 20 million lives are on the line, and repealing the ACA clearly puts partisan politics before the well-being and economic security of Americans. It’s a callous, irresponsible move that ignores the greater good for the benefit of a few.

Many Americans relying on the ACA now fear the future. A couple I spoke with in St. Louis, Mo., considered themselves lucky with 30-years of employer-provided health insurance before the unexpected happened. Diagnosed with a rare cancer four years ago, the husband underwent four surgeries and several chemo rounds. Then his illness forced him to go on long-term disability, changing his job status and his insurance, but protection provided by the ACA meant he couldn’t be denied insurance.

Last year, the Jenkins in Baltimore worried about paying for treatment for their 22-year-old son, diagnosed with testicular cancer. They enrolled in the ACA, and one month later, treatment started and all bills were covered. Now, they’re concerned that a repeal will force them to sell their home if the cancer returns.

They are not alone. Thousands of people who have benefited from the ACA have shared their stories online at acaworks.org, making it clear all they have to lose. Parents with disabled children; frail elderly people; those with chronic conditions like asthma, diabetes, HIV/AIDS; pregnant women; cancer patients and countless others will suffer and even die if there’s a repeal. Citizens of the wealthiest nation on earth, they fear uncertainty and economic devastation.

But it doesn’t have to be this way. The ACA isn’t perfect, but it can be improved. Despite semantics, Republicans and Mr. Trump prefer to repeal it without a replacement. Repealing the ACA is a choice. Congress could choose to work in a bipartisan effort to truly reform and improve the ACA. Instead, Republicans choose to serve corporate donors, choose to pursue partisan politics in a quest for power, choose to ignore the citizens who voted for them, choose to turn a blind eye on the greater good, and choose to visit this health care nightmare on all of us. They forget they work for We-the-People, and now is the time to remind them.

Rosalia Scalia (www.rosaliascalia.com ) is a writer in Baltimore.

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