Senate Republicans cleared one of their last procedural hurdles yesterday when the Senate Budget Committee voted to move the GOP tax bill to the floor. The bill would repeal the Affordable Care Act’s (ACA) individual mandate to buy health insurance, setting off a spike in premiums that the nonpartisan Congressional Budget Office predicts would cause 13 million people to lose their health insurance.

Why include an attack on the ACA in a tax bill? Because the GOP wants to take the savings from not helping millions of people get health care and use it to give corporations and the ultra-wealthy a massive new tax cut. And this time around, Senators Susan Collins (R-ME) and Lisa Murkowski (R-AK) who courageously opposed a nearly identical repeal-without-replace effort this summer have said they will support the tax bill even if it repeals the individual mandate and strips health insurance from millions of people. The bill also includes a huge new tax giveaway to Donald Trump, while raising taxes on graduate students (including health professionals) and blue state residents. The bill even includes language to undermine abortion rights.

On Wednesday, the Senate voted on a party line vote 52-48 to start debating the tax bill on the floor. There will be just 20 hours of debate, followed by a vote-a-rama where amendments are only discussed for 5 minutes before voting. Then the Senate could vote on final passage on Thursday or Friday. As with ACA repeal, the GOP only needs the support of 50 senators and Vice President Mike Pence to ram through a massive, unvetted bill with major ramifications for our health and our economy. As of right now, Republicans continue to negotiate and twist arms, and no one in the public has seen the final bill they will be voting on this week.

If the Senate passes its bill, there's a strong chance that the House will simply pass the Senate bill as-is, clearing it for Trump to sign into law by next week. This makes the next few days critical. Senators Collins, Murkowski, and others have flip-flopped because they haven’t faced the same public pressure, but there’s still time.

There are still a handful of issues that the Senate is negotiating amongst themselves, including a provision to automatically slash the social safety net if the bill doesn’t raise as much revenue as conservatives have promised. Manufacturing a debt crisis and then using it as excuse to attack Medicare, Medicaid, and Social Security has always been the subtext to Republican budget plans. But if a spending cut “trigger” is included in the tax bill and written into law, deep, automatic cuts in health care for seniors, low-income households, disabled individuals, pregnant people, and more is guaranteed.

It is crucial to call your senators at 1-855-972-9703 and ask them to oppose the tax bill. Tell them the GOP tax bill threatens the health and economic security of women and families living in your state.

Sarah Christopherson, MA, is the Legislative Director for the social justice campaign, Americans for Tax Fairness, and the NWHN’s former Policy Advocacy Director. Her 10 years working for Congress and her deep knowledge of health policy and consumer protection make her the NWHN’s issue area expert on federal health reform implementation and defense, drug and device safety and efficacy, and sexual and reproductive health.

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