The health care repeal that Republicans are pushing through Congress is a direct attack on the lives of black people throughout the country.

Just as these right-wing politicians are pushing us out of the voting booth, they want to push us out of doctor’s offices and hospitals, further into medical debt, and closer to the grave.

Some think repealing “Obamacare” will reset the clock to 2008. In truth, the repeal plan being considered by the Senate takes us back beyond 1964, before Voting Rights, Civil Rights, and before Medicaid.

Medicaid is the program that more than any other, opened the door to health care for African-American people in the United States, and the lives of black people are exactly what’s at stake in the fight over repeal.

The legislation proposed by Republican leaders doesn’t just gut the Affordable Care Act (ACA). It also aims to destroy Medicaid, cutting a quarter of its budget and capping funds, ending the guarantee that the program will be funded according to how much care is needed and used.

This will result in more than 22 million people across the country losing their coverage entirely, while many more will lose critical services they need – everything from help with long-term care to cancer treatment.

We know these cuts won’t be felt equally. Black adults are twice as likely to get their coverage through Medicaid than white adults. Although struggling people of all races will suffer under this health care repeal, the effects will hit black communities hardest.

African Americans have higher rates of diabetes, stroke and high blood pressure, and African American men are twice as likely to die from prostate cancer. All of these conditions are easily treatable with well managed health care, which is what the ACA is all about.

The cruelty of taking away health care is unfathomable. Many black adults got health insurance for the first time in their life under “Obamacare” when many states expanded Medicaid. Unfortunately, too many people were shut out of these gains because some states refused the Medicaid expansion.

When Louisiana finally opened Medicaid to more people, there were newspaper reports of patients crying with relief. These right-wing politicians want to steal that right out of their hands. They don’t care who lives or dies as long as they can hand over a giant tax break to their billionaire and corporate donors.

Speaker of the House Paul Ryan has tried to sell health care repeal by calling it “freedom.” How ridiculous!

That’s the emptiest, cruelest version of freedom I can think of – the freedom to go without health care you need and can’t pay for, the freedom to go bankrupt over medical debt, the freedom to die.

Without insurance, families face devastating financial consequences. More than half of all bankruptcies are due to insurmountable medical bills. Lack of health insurance isn’t freedom, it is a poverty sentence that can last for generations.

When it comes to health care, the Affordable Care Act didn’t get us all the way, just as Medicaid hasn’t either. But the ACA put us in the right direction, and it’s that progress the right-wing politicians want to destroy – and that makes them so afraid.

Janice “Jay” Johnson is the board president of People’s Action, a national organization with members in 29 states advancing economic, racial, gender, and climate justice. Johnson is a longtime youth advocate and community activist in Hampton and Newport News, Virginia.