You may not remember Senator John McCain’s courageous thumbs-down vote on the so-called “skinny repeal” bill to repeal Obamacare, but I do. I was up in the wee hours of the morning, watching from home. I was always at home then, only leaving to see doctors, get groceries, or attend public events to beg my Senator to protect our care. 

In a way, this was good preparation for the pandemic we’re living through now. Cancer patients and the immunocompromised know well the routine of wearing masks and using hand sanitizer, weighing every decision on whether to go out in public when the wrong decision can have deadly consequences. 

That night, we didn’t know how that vote was going to turn out but the patient community was watching avidly, our insurance and possibly our lives at stake. Watching C-SPAN in the middle of the night, I could only feel dread and disbelief that the people elected to have our best interests in mind are voting to strip health care from those of us most vulnerable and least able to survive without it. I remember the shock and then the joy when I realized that, for the moment, the ACA was saved. I clumsily kicked the trash can in my kitchen and scraped off the top layer of skin on my toe (your body during chemotherapy is not quick to heal). Bleeding a trail through my apartment that night in search of a band aid, I didn’t even care.

At the time of the vote, I had been fighting stage 4 Hodgkin’s Lymphoma. Three months earlier I walked into a doctor’s office with a nagging cough, and walked out with a stage 4 cancer diagnosis. I should have been preparing for my 41st birthday, but instead I was fighting for my life.

Crossing the unseen border from healthy to deathly ill nearly overnight, I was thrust into a scary new world of doctors and hospitals. It is hard enough to process that your body is trying to kill you. Now I had to cope with my elected officials going after the health care that was keeping me alive, too. 

The day after my first chemotherapy session in May, Republicans in the U.S. House voted to strip away my health care. A short while later, on July 27, 2017, Senate Republicans, including my now-Senator Cory Gardner, voted to dismantle the Affordable Care Act. But on July 28, John McCain famously gave a “thumbs down” to a vote on a full repeal of the ACA. I will remember that moment as long as I live. 

And I live because Obamacare literally saved my life. Without it, I would be bankrupt or dead. I’m self-employed and had junk insurance prior to the ACA. I know what happens if we have to go back to those days, and it does not turn out well for people like me. But Trump, Gardner, and Republicans in Congress will not stop attacking our care, even in the midst of a pandemic.

There is a case before the Supreme Court right now that could destroy the ACA, including its protections for people with pre-existing conditions, like me and maybe like you, too. Pre-existing conditions can range from the serious to the benign, from anxiety and acne to tuberculosis and metastatic cancer, but any of these conditions could mean you would be charged more in premiums, have related care excluded, or be denied a policy altogether.

135 million Americans have pre-existing conditions and millions more may join us as they recover from COVID-19. The after effects of surviving the novel coronavirus are still mostly unknown at this point, but this much I know: if insurance companies are given the option to refuse care to people who might need it, they will do so. We would be uninsurable without Obamacare. And many of us will die without insurance. I am in remission now, but if my cancer recurs, I might not be able to afford to treat it. Will COVID-19 survivors be able to get the future care they need?

The Affordable Care Act is ten years old now, and in that time we have seen that Republicans have no plan to protect us. Every proposed replacement leaves people with pre-existing conditions out in the cold. But they are still determined to strip our care to fund more tax giveaways for billionaires, and they whitewash their own records to hide it.

Three years ago, Republicans in the Senate showed us where they stand. Senator Cory Gardner has voted seven times against the Affordable Care Act, and many of his fellow Senators have voted that many times or more. 

Now, more than ever, we must fight to protect our care. Three years ago, we had Senator John McCain. But in 2021, we will not. 

Laura Packard is a Denver-based health care advocate, co-chair of Health Care Voter, senior advisor to Be a Hero, and founder of Health Care Voices, a non-profit grassroots organization for adults with serious medical conditions. Follow her on Twitter: @lpackard