New Jersey advocates stepped up their public campaign to protect the Affordable Care Act yesterday, insisting a repeal of the federal law would harm the economy and public health and could be a death sentence for nearly 800 state residents.

At the same time, President-elect Donald Trump’s pick to head national healthcare policy faced a grilling from Democrats in Washington, D.C.

Led by the NJ For Health Care Coalition, a baker’s dozen of advocates for healthcare, labor issues, small businesses, antipoverty causes, and human rights gathered at the State House with Assembly Speaker Vincent Prieto (D-Hudson) to urge Republicans in Congress to oppose a repeal of the ACA and to push Gov. Chris Christie to speak out in favor of the landmark law. Christie has praised aspects of the law — which has extended affordable coverage to nearly 800,000 state residents — but he has not taken a public stance on its potential elimination.

On Wednesday evening, the advocates fanned out around the state to hold vigils at offices of the New Jersey’s five GOP congressmen and deliver a letter urging them to put the needs of their constituents ahead of politics. Four out of the five voted with Republican leaders in Congress Friday to scrap the law, which Trump and the GOP have pledged to repeal; Congressman Tom MacArthur (R-Ocean) was one of only nine Republicans nationwide to join Democrats in opposing the repeal.

“That gives us a lot of hope,” said Maura Collinsgru, the healthcare policy director with New Jersey Citizen Action, who oversees the coalition, which also led rallies Sunday in Newark and Camden with Democratic Congress members that attracted some 500 people. Collinsgru was among nearly two dozen people who arrived at MacArthur’s Marlton office Wednesday evening to thank him for supporting the state’s needs. Ending the law would have a “devastating impact on individuals, on communities and on taxpayers in New Jersey,” she said.

A report released late last year by New Jersey Policy Perspective, a progressive think tank, warned that dismantling the ACA could result in a $3 billion state budget hole through a loss in federal Medicaid funds; endanger the jobs of some 86,000 healthcare and other workers hired since it took effect in 2014; and erase the insurance gains for some 500,000 residents who gained coverage through the Medicaid expansion and another nearly 300,000 who purchased discounted plans on the ACA’s marketplace, usually with the help of federal subsidies. Millions more have gained additional benefits, like free birth control and cancer screenings, new insurance protections, and no lifetime cap on coverage.

“This is much worse than [the] ‘death panels’ that Republicans wrongly claimed would result from the ACA — for some it would be a death sentence,” Castro said, recalling a common GOP rallying cry against the law’s passage, which erroneously suggested government bureaucrats would put people to death to save money.

“Make no mistake, this is going to be a game of lifeboat — who gets insurance and who doesn’t,” Collinsgru added, underscoring that access to health insurance doesn’t guarantee patients can get affordable coverage, let alone quality care. “This is a human rights issue, not a political one,” she said.

Prieto, who has championed efforts to address poverty, noted 10 percent of Garden State residents could lose their health insurance if the law is repealed. “This isn’t a game,” he said. “Many of those [who will lose coverage] are low-income workers already struggling to make ends meet as our economy lags the national recovery. The impact will be felt throughout the state, but mostly in urban areas. The state’s budget crisis will get markedly worse. Hospitals will be hurt as they’re forced to treat more uninsured patients. The adverse impacts will be felt far and wide.”

The distinction between insurance access and healthcare coverage, or care, was a key point for Democratic Congress members who fired questions at Trump’s nomination to lead the federal Health and Human Services department, U.S. Rep. Tom Price (R-Georgia), during the first of his confirmation hearings Wednesday. If approved, Price, a physician, who has strongly criticized the ACA and called for major changes to both Medicaid and Medicare, would oversee these programs.

Price refused to be pinned down on specifics by senators who sought his promise to protect these massive federal programs, which insure millions of New Jersey residents altogether, or on other benefits provided by the ACA, like access to free birth control or coverage for addiction treatment, according to media coverage of the hearing. He suggested people would not lose coverage under the Trump administration, but failed to provide details on how they would be protected. Price also blamed certain government mandates and problems with medical malpractice insurance — two common targets for physicians — for some of healthcare’s current problems.

One of the most illustrative interactions came with Sen. Bernie Sanders (I-VT), the former Democratic nominee for president, after Price said Americans deserve “access” to high-quality care. “I have access to buying a $10 million home,” Sanders said, according to multiple reports. “I don’t have the money to do that.”

Several of New Jersey’s 2017 gubernatorial candidates have also started to speak out on the issue. Democratic contender Phil Murphy joined the rally in Newark Sunday, calling a repeal of the ACA a “threat to justice.” And Assemblyman John Wisniewski (D-Middlesex) — who served as chairman for Sanders during his presidential bid — termed the GOP’s quest “a crisis of uncertainty” — and said it’s time to explore a single-payer insurance system that would cover all state residents. Assemblyman Reed Gusciora (D-Mercer) called for a similar concept last fall and U.S. Sen. Robert Menendez (D-NJ) joined advocates in November to encourage discussion of a “public option” plan, an idea debated at length when the ACA was approved by Congress in 2010.

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