I never intended to become a physician. Serving in the Peace Corps was my childhood dream, and I got to experience that dream in my 20s. But the hunger, preventable diseases and appalling maternity care I witnessed while living in northern Africa led me directly into medicine.

As a family physician, I care for a variety of ailments and patients of all ages. After seeing children disabled by polio or die from tetanus while working overseas, I know the importance of vaccinating Maine kids against preventable diseases. Providing prenatal care and supporting women through their pregnancies and births brings me joy. I am proud to support women’s decisions about their contraception. Preventive medicine, such as mammograms and colonoscopies, saves lives by detecting cancers early. Having seen families living in countries with failing medical systems, I have a deep gratitude for the riches we have here in the United States.

Yet, historically, we have had similar health care inequities to what I saw while in the Peace Corps. The Affordable Care Act was the best effort I have seen in my life to address these disparities. As a doctor, I want my patients to be able to access affordable health care without financial stress or gaps in coverage.

I am greatly concerned that President Donald Trump and members of Congress want to repeal the Affordable Care Act. Every time I am able to order a screening for colon cancer, perform an annual wellness visit and prescribe contraception for a patient with Maine Community Health Options coverage, I am grateful for the act. People across Maine, including our friends and neighbors, have been able to get and maintain coverage despite having pre-existing conditions, such as diabetes and prior heart attacks or even lifelong conditions, such as muscular dystrophy and cerebral palsy.

But the Affordable Care Act does so much more than cover illnesses. Preventive health care in well people helps avert catastrophic illness, terrible outcomes and astronomical costs. One patient of mine finally got an Affordable Care Act-covered mammogram that detected early breast cancer. She was diagnosed and treated, thanks to the Affordable Care Act. I am able to care for young adult patients up through the age of 26 because they were able to retain their insurance coverage under their parents’ plan. In this economy, jobs with benefits can be hard to find, so the additional years of coverage provide a vital safety net for our young adults.

In the U.S., insurance equals access. With a large portion of Mainers living in rural areas, the Affordable Care Act has provided greater access to insurance coverage through the marketplaces for individuals, such as fishermen and farmers, who could not previously afford to get coverage through private insurance plans.

What will the more than 75,000 Mainers who have purchased health insurance through the marketplaces do if the Affordable Care Act is repealed? Go to a Title X-funded clinic, such as Maine Family Planning or Planned Parenthood, for preventative health care? But Republican-led efforts to strip federal fund ing from Planned Parenthood, one of the nation’s leading providers of preventive care services for women and families, would further reduce health care access.

Without Planned Parenthood, millions of women would be without annual wellness visits, contraception, domestic violence screening, prenatal care, smoking cessation and STI testing. Without the Affordable Care Act and Planned Parenthood, women — my patients, your sisters, wives, daughters, mothers and grandmothers — would be in dire straits. The health care safety net is fragile, and existing clinics and programs would not be able to absorb Planned Parenthood’s patient load should it be ejected from federal health programs such as Medicaid.

I appreciate the concern of Sens. Susan Collins and Angus King for the health of Mainers and our health care safety net. I hope they will continue to consider how important the Affordable Care Act’s advances have been to our state and millions of Americans, and I hope they will vote to protect affordable and comprehensive health care for millions of Americans

Dr. Julia McDonald is a full-spectrum family medicine doctor caring for patients in the Augusta area. She is a fellow with Physicians for Reproductive Health.