Senate Republicans are once more trying to ram through a bill that would be devastating for women, families and LGBTQ people. The Affordable Care Act (ACA) has nearly cut in half the number of American women with no health insurance. Thanks to the ACA, the uninsured rate among working-age women dropped from 20 percent (19 million) in 2010 to 11 percent (11 million) in 2016. The Graham-Cassidy bill, by repealing the ACA and drastically cutting Medicaid funding, will reverse years of progress in increasing coverage.

Graham-Cassidy would end federal financial assistance that makes it possible for low-income women to afford health insurance. By completely phasing out the cost-sharing reductions and tax subsidies that reduce out-of-pocket costs, Graham-Cassidy could put health care out of reach for the over 9 million women who, as of 2014, were eligible for the tax credits under the ACA. The drastic restructuring of the ACA that would occur under Graham-Cassidy would disproportionately affect women, as women are more likely than men to go without health care for financial reasons. The financial strain would be exacerbated for women of color, who are already more likely than white women to be uninsured.

The Republican bill would eliminate the ACA’s Medicaid expansion and radically restructure traditional Medicaid, harming the 1 in 6 women aged 18 to 64 who rely on Medicaid for coverage. Under the proposed plan, 3.9 million women aged 18-64 who have gained coverage under Medicaid expansion (a growth of 29 percent nationally) would no longer be eligible for coverage. What’s more, Graham-Cassidy would gut traditional Medicaid, replacing it with a cap-and-slash system that will cover less and less each year. Older women, pregnant women, disabled women and families with children all rely on Medicaid for services and support that make it possible for them to lead healthy lives. As with Medicaid expansion, cuts to traditional Medicaid would disproportionately affect women, who make up two-thirds of adult Medicaid enrollees.

Graham-Cassidy rolls back critical consumer protections for women. The bill would allow states to waive the ACA’s ten Essential Health Benefits (EHBs), meaning that women would no longer be entitled to guaranteed maternity coverage, prescription drug coverage and mental health services. It would eliminate protections for the 65 million women with pre-existing conditions, and allow insurance companies to discriminate against survivors of domestic violence or women who’ve had a C-section. Before the ACA, only nine states required insurers participating in the individual market to cover maternity care, leaving women with hospital bills ranging from $32,093 for an uncomplicated birth to $52,125 or more for more complicated births.

The bill once again makes targeted attacks on Planned Parenthood and women’s reproductive health. Graham-Cassidy prevents women from using Medicaid or other forms of government health insurance at Planned Parenthood for services like cancer screenings, STD treatments, family planning services like birth control and more. Planned Parenthood is often the only provider in rural and other underserved areas for women to obtain needed health care. In addition, the bill would ban the use of federal financial aid to buy private health plans that cover abortion as early as 2018. As a result, in most states, plans would drop abortion coverage. In states like New York and California, which require abortion coverage, no one could use federal premium tax credits to buy private coverage.

The changes to the ACA and Medicaid that would take place under Graham-Cassidy would do irreversible harm to the health and well-being of women and our families. We can’t afford to go backward and jeopardize the health care gains we have made under the ACA.

Ann Danforth is the Progressive States Advocacy and Policy Manager at Raising Women’s Voices