While most people think the health care "repeal and replace" debate is behind us, there is in fact one repeal bill left standing – and it's just as bad, if not worse, than previous proposals.

The bill, sponsored by Senators Bill Cassidy and Lindsey Graham, is the GOP's last hope of tearing up the Affordable Care Act (ACA) – and they're trying to force it through before policymakers and the public can understand its implications. With no debate, only one public hearing and without a complete CBO score, the Senate will vote next week on a bill that could end coverage to over one million Pennsylvanians.

The Cassidy-Graham bill, like all previous ACA repeal bills, would undermine all the progress we've made in expanding health coverage. It would cause tens of millions of people to lose coverage, while costs would go up for millions more.

Medicaid expansion, which has extended coverage to over 707,000 individuals in Pennsylvania, would be eliminated. The ACA's marketplace subsidies, which help over 301,000 Pennsylvanians afford coverage – would be gone. Instead, states would get a much smaller, temporary block grant of money. Because the amount of money would be fixed each year, Pennsylvania would be on the hook for any and all unexpected costs from recessions, natural disasters, public health emergencies, or prescription drug price spikes. And, after 2026, this money would disappear altogether.

The core Medicaid program in all states- not just those that expanded Medicaid under the ACA- would be radically restructured and cut, putting at risk care for seniors, people with disabilities and families with children, including services such as home- and community-based care for seniors and people with disabilities

The bill would slash federal funding for health coverage for Pennsylvania by more than $15 billion in 2027 alone as a result of these changes.

Pre-existing conditions protections? This would be left to the whims of each state. In fact, a state could let insurers charge people with health conditions exorbitant, unaffordable premiums and sell plans that leave out essential benefits like maternity care and mental health care.

Women's health is also on the line: the bill sneaks in a provision that prohibits states from reimbursing Planned Parenthood for preventive health and family planning services.

It's time to reject this partisan bill and focus on a bipartisan effort to strengthen our marketplace, control costs, and preserve and expand coverage. And that's exactly what members of Congress from both parties, with the help of governors and insurance commissioners, are doing now. In fact the Pennsylvania Insurance Department estimates that if we don't receive certainty around cost sharing payments we could see rates increase by 23.3 percent instead of the proposed 8.3 percent proposed rates in the health insurance marketplace.

We only have a few days left. From now until September 30, we need everyone – experts, patients, hospitals, seniors, people with disabilities and Pennsylvania families – to defend Medicaid and the health of Pennsylvania and people across the county.

One repeal bill is left standing. Let's make sure it's the last.