With the votes they cast one year ago, Senate Republicans showed voters exactly what they’d do to their health care. In about 100 days, voters will hold them accountable for it.

Across the country, hardworking people are struggling to keep up with soaring premiums and the crippling fear that their pre-existing health conditions will no longer be covered by their insurance.

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And their fears are valid.

Among the many proposals aimed at turning back the progress we’ve made has been a bill that would target older Americans and allow insurers to charge them nearly five times the rate that younger people pay.

For many, the rising cost of health care premiums will force them to make impossible choices between keeping the lights on for their families or having the treatment they need to survive. It’s an excruciating choice that most Republicans pushing these decisions will never have to make and one that no American should have to.

Even after their repeal efforts stalled in Washington, Republicans found new ways to undercut the health care law: 20 Republican attorneys general – including Senate candidates Josh Hawley in Missouri and Patrick Morrisey in West Virginia – doubled down last month by filing a lawsuit that claims the provisions of the ACA that protect people with pre-existing conditions are unconstitutional.

The elimination of protections for people with pre-existing conditions would drastically harm lives in states like Missouri, Indiana, West Virginia, and Tennessee which have larger populations of non-elderly people with these conditions.

The Republican effort to dismantle these protections is not only destructive, but wildly unpopular with voters. A review of public polling over the last 18 months reveals key trends that show the impact health care is having on the midterms.

Since last year, polls from Politico , Fox News and Quinnipiac confirmed voters did not approve of the Republican health care agenda. More recent surveys from CNN , CBS and PPP confirm that with just over 100 days until the election, public opposition to the Republican approach remains strong.

Worse news for Republicans: voters are holding them responsible for rising health care costs. A June NBC/WSJ survey found that half of Americans -- including Independents by a 30-point margin -- blame the president and congressional Republicans for health care cost increases. Another poll fielded that same month by CBS found that one in four voters say the GOP’s recent changes to health care have hurt their coverage and raised their costs.

It didn’t have to be this way. We could have worked across the aisle to find bipartisan solutions that bring down costs, protect essential health benefits and improve the health care system. Instead, the destructive GOP policies have hurt Americans and voters are ready to make their voices heard.

The GOP started the fight against affordable health care and now the voters will finish it at the ballot box with a clear and resounding message: stay away from our health care.

Van Hollen is chairman of the Democratic Senatorial Campaign Committee.