We should all be alarmed by today’s vote in the U.S. Senate to move forward debate about repealing the Affordable Care Act. Since 2014, the ACA has provided health insurance coverage for millions of previously uninsured Americans, including more than 600,000 people in Cook County.

Repeal of the ACA is estimated to result in 32 million Americans losing insurance coverage, according to the Congressional Budget Office. Repeal and replacement of the ACA, as contemplated by the Better Care Reconciliation Act (BCRA) proposed by the Senate would leave 22 million people uninsured. That’s not better care. That’s no care.

The Cook County Health has seen a significant reduction in the number of uninsured patients we serve. Half of our patients used to be uninsured. Now, thanks largely to Medicaid expansion, one third of our patients remain uninsured. That change is related to a one-for-one transition from uninsured to Medicaid-insured.

Repealing the ACA could result in a $300-800 million impact to our health system, at a time

when we can least afford to absorb such a burden. More importantly, it would cruelly strip health coverage-including preventive care and behavioral health services-from countless individuals who for too long went uncovered.

As a society, we must decide if change, such as BCRA, is likely to improve or degrade the health of our neighbors and our communities. A majority of Americans believe the ACA can be improved, but modifications under current consideration in Congress represent a dangerous step backwards. The changes proposed thus far are likely to displace more from insurance, raise premiums in the insurance marketplace, and transfer wealth from the most vulnerable in our society to the wealthiest.

For those who want to protect the coverage offered under the ACA, I encourage you to reach out to your elected officials. Volunteer with an organization that advocates for positive health policies. Talk to your friends and family about why they should be engaged too. Make your voice heard.

Dr. Jay Shannon, CEO, Cook County Health