Just days into the new congressional session, Republicans are acting aggressively to repeal the Affordable Care Act (ACA), with little consensus on what will replace it. Should they succeed, as others have noted, the impacts on California’s residents and economy will be severe. California wholeheartedly embraced the ACA and as a result, rates of uninsured have dropped by half, to just 11% of the state. Repealing the law would mean that 4.9 million Californians who either bought insurance on the exchange or became eligible for Medi-Cal will lose their coverage.

This threat is bad enough, but it will be even worse due to another grave hazard: climate change.

As a physician, I see the health – and health care—impacts of climate change firsthand with my patients. Warmer temperatures make ground-level ozone worse, leading to more asthma attacks and problems for people with heart disease. Smoke plumes from more severe wildfires are driving up emergency room visits for asthma and bronchitis. And while recent storms will make a dent in California’s long drought, my colleagues in the Central Valley see thousands of families that still don’t have clean water for drinking and sanitation.

Low income communities and communities of color will bear the greatest burden if Obamacare disappears, and these same communities are disproportionately affected by the health impacts of climate change. As heat waves become more frequent, we are seeing more heat illness as well as impacts on those with asthma, heart disease, diabetes and kidney disease. In Los Angeles, African Americans are more than twice as likely to die in a heat wave than other city residents. For those already struggling to cope with the rising health impacts of climate change, access to affordable health care is a critical, life-saving resource

California has been a national leader in addressing climate change and ensuring access to health care. But we can’t address these problems alone. If we want to protect and improve the health of all Californians, we need congressional and state leaders across the country to oppose all proposals that slow efforts to address climate change or dismantle the ACA and reduce access to the care that all Americans, but especially our communities need in the face of climate change impacts on health.

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Dr. L. Khadijah Lang is President of the Golden State Medical Association and a Family Practice physician in Los Angeles. The Golden State Medical Association is the California affiliate of the National Medical Society, which represents African-American physicians. Over the course of its 117-year history, the NMA has fought for the right of all Americans to have access to high quality, affordable medical care.