As the country delves into the throes of an impeachment inquiry and a tumultuous election year, another threat to our communities looms large. The 5th Circuit Court of Appeals is currently deliberating whether the Affordable Care Act (ACA) is unconstitutional, leaving over 130 million Americans’ health care hanging in the balance.

The decision could be made as early as this month. The impact will be devastating to communities around the country, and hits home particularly hard. If the ACA is repealed, millions of Pennsylvanians’ access to affordable health coverage is at stake. Nearly a million people across the state would become uninsured. Insurance companies could deny coverage to over 5 million Pennsylvanians who have a pre-existing condition. Medicaid, which almost 20 percent of Pennsylvanians depend on, could be cut by an estimated $5 billion in the state, and more than 275,000 seniors could pay more for prescription drugs.

Growing up, the gravity of the health care system’s impact had always been real to me. I watched my father, a black veteran of the Air Force, suffer from depression and diabetes, hardly ever able to keep both his health and our family’s financial needs equal priorities. I watched my mother suffer to afford the prescription drugs she needed after a critical car accident because our insurance couldn’t keep up with rising drug costs. Many of us feel a sense of hopelessness when we’re close to health-related suffering because it seems as though all we can do is watch.

For people of color, the implications are especially dire. Existing inequities in the state’s health care system have resulted in stark disparities in health outcomes, with black Pennsylvanians more likely to suffer from chronic diseases and also be unable to afford the prescription drugs they need. Allowing insurance companies to deny people access to affordable, comprehensive coverage will only exacerbate the system of inequality people of color already bear the brunt of.

As we get closer to a critical election year for our country, the time for simply watching is long gone. The fact that Republicans voted to repeal and undermine the Affordable Care Act, even though the majority of Americans favorably view the law, should be at the center of the 2020 debate—both for the presidential and Senatorial races. While Democratic presidential candidates spent much of Tuesday’s debate debating their different approaches to amending the health care system, the need for unity on protecting Americans’ existing coverage got less airtime.

Nearly three years since Donald Trump’s election, the Senate and Trump administration still don’t have a viable plan to replace the law—which is why they’re actively planning to delay any changes until after the election despite what the court decides. In other words, they ultimately plan to drop a bomb on Americans’ health care, when it’s politically feasible, and run.

Impeachment and the possible crimes committed by the Trump administration will be an ongoing political saga that will undoubtedly shape this election (and possibly American history). But it is not at the core of what Americans, and Pennsylvanians, care most deeply about. Our representatives should be held accountable for their role in putting the health care of millions of Pennsylvanians at risk, from Sen. Pat Toomey to the nine PA representatives who voted yes on the original repeal bill.

For people like me, health care isn’t a political issue. It’s one of the biggest deciding factors in whether, and how, you live. Tell our representatives to stop playing with it.

Rosalina Jowers is a public policy researcher and writer from the Philadelphia area.