As the House of Representatives prepares to hold another vote on repealing the Affordable Care Act, it's easy to dismiss the effort as political theater. But for millions of Americans who rely on the law's benefits and protections, the devastating effects of repeal would be all too real. Here's what repeal would mean in concrete terms for families in Minnesota and across the country.

Thanks to the law, all Americans with insurance are now protected from some of the insurance industry's worst abuses, like having their coverage canceled when they get sick just because they made a mistake on an application, or facing a lifetime dollar cap on their benefits. Already, 2,043,000 Minnesota residents, including 754,000 women and 553,000 children, are free from worrying about lifetime limits on coverage.

For people like Judy, a nurse I met who's battling stage four breast cancer, these protections can be the difference between life and death. Judy has good insurance, but her expensive radiation and chemotherapy treatments mean that without the law she'd likely hit her lifetime cap in just a few years. For Judy and millions more Americans, repeal would mean a return to knowing they could lose their coverage at any time.

For tens of millions of Americans with health insurance, repeal also would mean paying more for preventive care. Under the law, 54 million people with private health insurance, including 1 million people in Minnesota, can now get free preventive care like vaccinations, checkups and cancer screenings. Repeal would mean that hundreds of dollars in savings a year could disappear.

For people in communities facing a shortage of doctors and nurses, repeal would make it even harder to get the quality care they need to stay healthy. Today the health care law is building and expanding community health centers in some of America's most medically underserved regions and is training thousands of new doctors and nurses who will provide primary care around the country. This investment would slow dramatically if the law were repealed.

Repeal would also take us back to the days when insurance companies were not accountable to anyone. With the new health law, your insurance company now generally has to spend at least 80 cents of every premium dollar on health care and quality improvements, not on CEO salaries or advertising. If it doesn't, you get a rebate. This summer, 56,000 Minnesota families with private insurance will benefit from an average of $160 in rebates from insurance companies as a result of this new provision.

For seniors, repeal would mean losing free preventive care, like cancer screenings and annual wellness visits now available in Medicare without any copay. Millions of seniors who reach the Medicare prescription drug donut hole would also see their 50 percent discount vanish if the health care law is repealed.

Since the law was enacted, 5.2 million Medicare beneficiaries in the donut hole have saved more than $3.7 billion on prescription drugs. In the first five months of 2012, nearly 10,000 people with Medicare in Minnesota received an average savings of $644. Repealing the law would add hundreds of dollars in additional costs for many seniors at a time when they can least afford it.

And repealing health reform also would stop our promising new efforts to crack down on Medicare fraud. The health care law provides new law enforcement and surveillance systems that helped authorities recover a record $4 billion in taxpayer dollars last year alone. In recent years, every dollar we have put into fighting fraud has returned more than $7 to the taxpayers, but this will slow to a halt if the law is overturned.

Finally, repeal means that millions of Americans would lose their insurance. Three million young adults may not be covered any longer on their parents' health plans, including 35,000 in Minnesota. Insurance companies could once again throw children with preexisting conditions like asthma and diabetes off a family policy, or refuse to cover their illness. And repealing the health care law would threaten the lives of 424 people in Minnesota with serious health conditions like cancer who are getting life-saving care today thanks to a program, created by the law, for people who cannot otherwise find coverage.

The Supreme Court decided last month to uphold the Affordable Care Act. To ensure that middle-class families finally get the security they deserve and protection from the worst insurance company abuses, we need to move forward on the Affordable Care Act. The last thing Congress should do is repeal these critical protections.


Kathleen Sebelius is secretary of the U.S. Department of Health and Human Services.