This week, lawmakers in Washington were sworn in for the new session of Congress – and Republicans took the first step toward repealing the Affordable Care Act. The Senate introduced a budget resolution implementing a special legislative process called reconciliation that could repeal some, though not all, of the provisions of the ACA. The reconciliation process only requires 51 votes in the Senate, providing the majority party a path without the need for Democratic support. Republicans have set a target date of Presidents’ Day (February 20) to put a finished repeal bill on incoming President Trump’s desk. The hospital community agrees that the health care law needs reform, and we’ve offered solutions to fix it. But any repeal must be paired with a replacement bill, to preserve coverage for millions of Americans. However, if Congress decides to repeal the ACA without simultaneously providing similar coverage, it is essential that they include the repeal of funding cuts to Medicare and Medicaid payments for hospital services that were included in the ACA. These funding reductions, if not restored, coupled with the loss of coverage, will jeopardize care. They cannot be sustained, and could cause reductions in services or even closure for some hospitals. That would be harmful to the many patients who rely on our hospitals and to the communities we serve. The AHA’s vision is of a society where every person can reach their highest potential for health. Repeal without simultaneous replacement would be a step backward America can’t afford to take.