Two weeks ago, America dodged a bullet. The healthcare repeal plan, which sold out seniors, children, families and hospitals in favor of tax cuts for the wealthy, was ultimately pulled from a vote at the very last minute. This was a victory—but the fight is not over as reports from Washington show new headway being made by President Trump and GOP dissenters.

In preparing for the next fight, it’s important to remember what the healthcare repeal would have done to West Virginia. We need to hold our congressional delegation accountable for the blueprint they supported—and for the devastating impacts they thought were acceptable.

According to the nonpartisan Congressional Budget Office, the Republican healthcare repeal bill would have meant 24 million fewer people nationwide would be insured. To put that number in context, that’s as if the

populations of 17 states—Nevada, Kansas, New Mexico, Nebraska, West Virginia, Idaho, Hawaii, New Hampshire, Maine, Rhode Island, Montana, Delaware, South Dakota, North Dakota, Alaska, Vermont, and Wyoming—all lost their healthcare. In West Virginia, it would have meant 200,000 of people would have lost insurance.

In the last hours of negotiating, Republicans reneged on the promise to protect people with pre-existing conditions, which would have been devastating to the 133 million Americans—or 51 percent of all non-elderly adults—that have at least one pre-existing condition, whether high blood pressure, high cholesterol, diabetes, cancer, a mental illness, substance abuse disorder, even a sports or hunting injury in the past, or simply being a woman. In fact, research shows that right here in West Virginia there are over 799,000 people that have a pre-existing condition – that’s almost half of the state’s population – that could again be charged much higher premiums or have swiss-cheese plans that don’t cover any health care related to their pre-existing condition. . The Republican healthcare plan would mean they wouldn’t be able to find the coverage they need at any price, much less an affordable one.

That’s because Republicans in Congress wiped out the Affordable Care Act’s (ACA) guarantee of Essential Health Benefits, nationwide rules on what health insurance plans have to cover. For example, before the ACA, 62 percent of plans lacked maternity coverage; 34 percent lacked coverage for substance use disorder treatment; 18 percent lacked coverage for mental health services; and 9 percent lacked prescription drug coverage.

Without Essential Health Benefit standards, insurers would likely stop covering those services as a way to discourage enrollment by sicker, more costly enrollees. And if plans did cover such costly treatments, they would charge exorbitant premiums because only those with pre-existing conditions would enroll in them. The ACA’s guarantee of “community rating” that protects West Virginians from exorbitant premium hikes if they have any pre-existing condition also would be gone.

Protections for people with pre-existing conditions are important to all West Virginians. Over time, as we grow older, none of us will dodge the bullet of needing these protections so we can continue to afford quality health insurance that is there when we need it.

— Chantal Fields is the executive director of West Virginians for Affordable Health Care.