Who would have thought that in 2017, we’d still be debating whether access to timely, quality, and affordable health care is a right and its provision a responsibility of the U.S. government?

Yet, here we are – the richest nation in the world, where over 28 million people, excluding the elderly, have no health insurance. Where one in four adults with private health insurance forgo necessary medical treatment because of the cost. Where working people – a disproportionate number of whom are black and brown – die of poverty and inequality on a daily basis.

On a macro level, the U.S. has some of the worst health outcomes in the industrialized world. As Dr. Stephen Bezruckha, professor at the University of Washington School of Public Health likes to put it, “If there were a health Olympics, the U.S. wouldn’t even medal.” Indeed, we’d be dead last. As a country we perform so poorly on certain quality of life measures that, as the World Health Organization points out, our maternal mortality rates are worse than those of Libya, Iran, and Turkey. And this is before we even acknowledge that black women die in childbirth at a rate three to four times higher than white women in the United States.

Broadly speaking, health care is not the most important factor when it comes to understanding our national health status. It’s more so shaped by factors like skyrocketing inequality, unhealthy environments, and a lack of public investment in early life through supports like national paid family leave. But a privatized and dysfunctional health insurance system only exacerbates the issue.

This shouldn’t surprise you. If you’re not feeling the strain of our overly expensive health care system, you undoubtedly know someone who is. Or, at least you’ve seen news reports of people protesting Affordable Care Act repeals – like today, when police arrested disabled people protesting the Graham-Cassidy bill, which would bring a swift end to the ACA’s protections for people with preexisting conditions, both in terms of out-of-pocket costs and requirements around which services must be covered. These people could die if they lose their coverage.

It’s mindboggling to think that Congressional Republicans are at this very moment conducting secret backroom deals on how to best strip away access to health care for at least 32 million more people. According to the Center for American Progress, pregnancy-related premium costs would go up by $17,320 under the Graham-Cassidy bill. Health costs would increase by over $26,000 for a person with rheumatoid arthritis and over $142,000 for someone with metastasized cancer.

According to Avalere, a D.C. based health care consulting firm, the latest ACA repeal bill would also eliminate federal funding for health care by $4.15 trillion through 2036; Washington State would see $110 billion in cuts by 2036 through the restructuring of Medicaid payments and rollback of ACA provisions. Passage of this bill would undoubtedly signify a return to bleaker times. Uninsured rates will soar when families have to choose between paying rent or paying their premiums, and medical bankruptcies will become the norm for those with chronic or acute conditions. Suffering, stress, and hardship – all preventable – will abound.

We have seen the American people show up faithfully and on every front to protest Republican attacks on the Affordable Care Act, and we have observed instances of moral courage from a number of legislators on that side of the isle – surely inspired by the voices and experiences of their constituents.

The ACA is certainly not without its problems. Premiums have gone up for about 15 percent of people on the exchanges. But it’s led to an unprecedented decrease in the amount of uninsured people in the U.S. – and in Washington, we went from a 14 percent uninsured rate in 2013 to 6 percent in 2016. It’s not perfect, but the ACA is an improvement from where we were before.

The fact that we’re still fighting shows that we still have miles to go in building a health care system that truly works for everyone. If the federal onslaught stopped tomorrow and we were able to keep all of the gains we’ve made through the Affordable Care Act, it wouldn’t be enough. We have to keep pushing ahead toward a real and meaningful shift; away from relying on private insurance industry and its complex administrative structures and spiraling costs and profit motives, and toward a universal system where everyone can find an affordable coverage option that meets the needs of themselves, their families, and their employees.

EOI is working on a plan to extend more affordable and comprehensive coverage to all Washingtonians through a grant from the Pacific Hospital Preservation and Development Authority. We are exploring policy pathways that allow us to build on what works: Medicaid, Medicare, and public employee benefits programs all feature promising elements and could pave the way toward universal coverage on a state or national level.

But when politicians in Congress are fighting over bills that would worsen health care in this country, rather than improve it, it makes progress that much harder. We need to encourage collaboration and political risk-taking among our elected representatives – the ability of people to live healthy lives should not be a partisan issue.