The American Nurses Association denounced the Republican House healthcare proposal in a Wednesday letter, saying the plan to repeal and replace ObamaCare does not “improve care for the American people.”

“The American Health Care Act threatens health care affordability, access, and delivery for individuals across the nation,” the ANA wrote.

The ANA, which represents over 3.6 million nurses, cites concerns that non-partisan experts such as the Congressional Budget Office and the Government Accountability Office have not weighed in on the plan.

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“Any legislation that would fundamentally alter healthcare delivery and deeply impact patients and providers deserves thoughtful, deliberate and transparent consideration,” the letter says in part. “ANA strongly urges congress to allow opportunity for considered public and stakeholder feedback in the face of reforms that would have a far-reaching and personal impact on the lives of millions of people.”

The ANA is the largest U.S. organization of healthcare professionals with a record of being vocal about healthcare issues.

The American Hospital Association and the American Medical Association, the nation’s largest doctors group, have also come out against the GOP plan.

ANA President Pamela Cipriano slammed the health proposal in a tweet Wednesday, saying the AHCA fails to fulfill the promise that it would be better than ObamaCare.

In December, the ANA wrote a letter to Trump urging him to keep certain provisions of ObamaCare including allowing children to stay on their parents’ health plans until they are 26 and also to prevent preventing people with pre-existing conditions from being denied health insurance coverage, according to a Forbes report.

The nurses group, which supported the Affordable Care Act when it was a legislative proposal, has repeatedly slammed efforts to overturn the healthcare overhaul.