Rumor is that Senate Republicans are scrambling to hold a vote on the American Health Care Act before their July 4 recess. They are eager to fulfill a promise to destroy the Affordable Care Act, also known as Obamacare. So secretive has been their work to revamp one-sixth of the U.S. economy, that Senate Majority Leader Mitch McConnell has bypassed the normal committee hearings, curbing open public debate in the process. At this juncture, I believe it is important to reflect on just how inadequate our health care system was for tens of millions of Americans in the years before the ACA was passed.

I have lived with a serious chronic illness for 17 years, and was keenly aware of dangerous trends in our health system and in insurance offerings that inspired the writing of the Affordable Care Act. Prior to the ACA, nearly 20 percent of the non-elderly population lacked insurance, and far too many families suffered complete bankruptcy due to an illness. I watched nervously as insurance premiums crept ever higher while deductibles ballooned. We were paying more and more to the insurance company for the “privilege” of paying more out of pocket for our own health care. Many were being denied coverage altogether due to a pre-existing condition. Some with particularly serious and costly conditions found their insurance terminated when they reached a lifetime limit on coverage.

The ACA, while not perfect, removed some of the nightmares in U.S. health care. These elements must be preserved in any new system. In short, health care for all people must be accessible, affordable and comprehensive:

• Accessible: We must assure access to health insurance coverage for people with pre-existing conditions, like MS, cancer, diabetes, and heart disease. And people with serious long-term health problems should not face lifetime caps on health care.

• Affordable: Under the ACA, low-income people receive premium support and assistance with deductibles and co-pays. This assistance has given many people access to healthcare for the first time. Now we find ourselves having to grapple with the costs of this pent up demand for health care. But can anyone deny that allowing everyone access to health care is a good thing? None of us would wish to confront the choice between feeding our children or buying the medicine that helps us remain healthy enough to remain productive.

• Comprehensive: The ACA demands that coverage include access to essential health services that are good health care. They include mental health services, access to life-saving preventive screenings (mammograms, colonoscopies) and specialists. These are all important gains that we should fight to preserve.

We fought hard for these guarantees and now face the real possibility that Congress will roll back guaranteed access for people with pre-existing conditions, the promise of affordability, and access to specialists. Under the Republican AHCA plan that was developed by the House, older adults could see premium increases of many thousands of dollars; insurers could again impose lifetime caps; and income-based subsidies would largely disappear. And proposed deep cuts to Medicaid would deal a huge economic blow to the state of Maine.

To create an equitable, sustainable health system — one that meets the needs of all Americans, rich and poor, healthy and sick, old and young — will demand hard work, public input and robust discussion. It won’t happen overnight.

Our own Sen. Susan Collins has spoken up for the creation of a bipartisan committee that would include women as well as men — Republicans and Democrats working together to assure accessible, affordable and comprehensive health care for all Americans. That has not happened. I hope Sen. Collins will vote no on this bill that comes up woefully short.

Robin Steinwand retired from public health and lives in St. Albans. She co-chairs the Government Relations Committee of the National Multiple Sclerosis Society in Maine.