At a CNN town hall on Thursday, a Republican cancer survivor put a very personal face on the national debate over the Affordable Care Act (also known as Obamacare). “Because of the Affordable Care Act, I’m standing here today,” survivor Jeff Jeans of Sedona, Arizona told House Speaker Paul Ryan.

Jeans explained to Ryan that he used to oppose the ACA himself—until he was diagnosed with cancer at 49 years old. Jeans was given six weeks to live without treatment. Jeans offered to pay for his care out-of-pocket, but he was told he needed insurance coverage in order to be treated. “We offered three times the cost of my treatment, which was rejected,” Jeans explained. “They required an insurance card.” As a small business owner, Jeans wasn’t able to get coverage through his job. (Since Jeans also had a pre-existing condition, he likely would have had a very difficult time getting insurance in the years before the ACA existed.) Fortunately, he was able to sign up for coverage through the ACA and receive the life-saving care he needed. “I want to thank President Obama from the bottom of my heart, because I would be dead if it weren’t for him,” he said.

The ACA was signed into law in 2010 with the intention of ensuring that all Americans had access to affordable health coverage. While the program is largely imperfect—monthly insurance premiums and taxes have increased for many—it provides options for millions of people who were previously living without coverage. Among other benefits, the plan prohibits insurance companies from denying coverage to people with pre-existing conditions. In the first five years after the ACA’s launch, more than 16 million people received insurance coverage—many of whom couldn’t afford coverage before the ACA.

President-elect Donald Trump has long stated that he plans to repeal the Act when he takes office. On Wednesday night, the Senate passed a budget resolution that makes way for Congress to defund the ACA. This move is a first step toward potentially dismantling the program. (That process is somewhat confusing, so we’ve got a breakdown of what it all means here.)

During Thursday’s conference, Ryan said that he and fellow Republicans plan to replace the ACA with “something better.” However, it’s still unclear exactly what that new plan could be. If the ACA were repealed without an immediate replacement, millions of Americans would be negatively impacted. About 22 million people would become uninsured. The individual insurance marketplace would cease to exist. Insurance companies would once again be able to deny or drop patients who have pre-existing conditions. Young people would no longer be able to stay on their parents’ insurance until age 26, and women of childbearing age could be charged extra or even denied coverage due to the costs of prenatal care.

Not surprisingly, Jeans’ discussion with Ryan is eliciting powerful responses across the country. His experience echoes that of so many other Americans who credit the ACA with saving their lives—and it reflects the anxieties of some of the millions who stand to lose coverage if the ACA is repealed.

Watch Jeans’ discussion with Ryan below.

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