Late last week Senate Republicans finally released their secretly crafted health care plan, and yesterday the Congressional Budget Office published its score of the bill. Here’s the bottom line: the bill is designed to cut taxes for health care corporations and the wealthy; it would pay for those cuts by slashing public spending on health care for poor, working class, and middle class people; and it would result in 22 million people losing insurance and tens of thousands of people dying every year.

The most profound effect of the Senate plan would be a wholesale restructuring of Medicaid. Since its creation in 1965, Medicaid has made affordable, quality health care available to millions of low-income Americans. It is not perfect—there are gaps in benefits, millions remain left out, and too many providers don’t accept Medicaid payments—but it is nevertheless a critical public program that guarantees health care as a right to most lower-income Americans. The Senate bill (and the similarly draconian House plan) would cut and cap federal Medicaid payments to states. These cuts would force states to push people out of the program, limit eligibility for new enrollees, and slash coverage for those who remain enrolled. Medicaid as we know it, which guarantees health care as a right and a public good, would cease to exist.

The human toll of these cuts would be devastating, and would fall on people in an already dire situation. Health care prices, which are set by insurance, hospital, and drug corporations, are already impossibly expensive for most people. Last year cost barriers forced 63 million people, a third of American adults, to forego necessary medical care. By cutting public health care spending for precisely those least able to afford medical costs, Republican leaders would inflict unthinkable harm on people’s lives.

This is not business as usual. This is an emergency. The most immediate thing any of us can do is to make calls, participate in civil disobedience, and otherwise make clear to Republican Senators that they cannot pass this bill.

But we cannot stop at defending Medicaid and the Affordable Care Act: the United States needs a fundamentally different approach to health care that does not allow corporate profiteers to drive up prices and deny people care. We need universal, publicly financed health care that is financed through equitable taxation and provides health care as a public good to all.

The policy solution is clear, but to win it will require building enough people power to overcome insurance industry opposition and change what is politically possible. What’s needed is ground-up organizing by everyday people in the places we live. NESRI remains as committed as ever to supporting state-based organizing in California, Maine, Pennsylvania, New York, Vermont, and around the country.

Let’s stop Senate Republicans from doing irreparable harm to Medicaid and to millions of people’s lives. And then let’s redouble our commitment to supporting the long, slow work of organizing to change what is politically possible and guarantee health care as a human right once and for all.