Who do you trust when it comes to your health?

I trust my favorite doctor or nurse. When it came to my mom's recent illness, I trusted a particularly dedicated, knowledgeable, and good-natured home care aide.

I, for one, am inclined to listen when 27 different groups of Pennsylvania health care professionals agree. Congress's efforts to repeal and replace the Affordable Care Act are headed in the wrong direction.

I especially listen when those 27 include Pennsylvania doctors (including pediatricians), nurses and nurse practitioners, community clinics, hospitals, dentists, nurse midwives, athletic trainers, rehab centers, nursing homes, home health aides, and others.

Full disclosure:  the organization I lead—The Hospital and Healthsystem Association of Pennsylvania—is on that list. My job is to advocate for hospitals and their patients.

Let me tell you, among the 27 of us, we sometimes disagree about how best to improve Pennsylvanian's health care. But on this issue, we wholeheartedly agree. Being able to afford health insurance is crucial to the lives of our patients.

We are all concerned about the American Health Care Act, the U.S. House of Representatives' plan to repeal and replace the Affordable Care Act. We put our thoughts into this letter to Pennsylvania Senators Pat Toomey and Bob Casey. We told them that the American Health Care Act jeopardizes the health insurance of too many Pennsylvanians, leaving them one health care crisis away from bankruptcy.

As I explained (I hope clearly) in an earlier blog, three kinds of patients are most at risk of losing their coverage:

  • Middle-aged, pre-retirement Pennsylvanians

  • People with pre-existing conditions

  • Working families whose household incomes are low

Unfortunately for Pennsylvanians, many of us belong in one or more of these categories. That's why the House plan hurts Pennsylvania more than other states.

We are the fifth "oldest state" in the nation. Compared to other states, we have a greater percentage of people who are nearing, or beyond, retirement age.

For older Pennsylvanians who buy their own health insurance—but are too young for Medicare—coverage may well be unaffordable. Premiums could go sky high, as much as $16,000 a year.

Six out of every 10 Pennsylvanians have pre-existing conditions because they have a chronic disease like high blood pressure, diabetes, or asthma. Coverage is at risk for these patients.

Adults in working families with low incomes—be they city or rural—would likely lose the coverage they received as a result of the Affordable Care Act. The earlier blog explains who gained coverage, through the expansion of Medicaid, and the plan to phase it out.

We are in the throes of an opioid epidemic. The Affordable Care Act has helped more than 125,000 Pennsylvanians enter drug and alcohol treatment.

Fortunately, the House plan to repeal and replace the Affordable Care Act is just a start. The U.S. Senate is working on it now.

With our letter, 27 Pennsylvania heath care organizations spoke with one voice to Senators Toomey and Casey. We urged them to speak up for our state during the coming weeks and months.

We must protect the Pennsylvanians who got coverage, many for the first time, with the Affordable Care Act.

Please consider adding your voice to ours.

Andy Carter, is president and CEO of the Hospital and Healthsystem Association of Pennsylvania.