We are particularly concerned that repeal would reverse the course of making prescription drugs more affordable for seniors. The legislation approved by the House could require seniors to repay the government. As a first step to reducing the cost of prescription drugs, the ACA provided a $250 rebate check to seniors who fell into the "donut hole" -- or gap in prescription drug coverage -- in 2010. Repeal could force 3 million seniors to repay the government the $250 that they received last year.

Richard Foster, the Chief Actuary for the Centers for Medicare and Medicaid Services (CMS), has said that "in theory," seniors would have to return the checks if repeal becomes law. As you know, the burden of returning these funds will be significant on these millions of American seniors. In most circumstances, the individuals have already spent the funds, making the government's attempt to claw back these payments both impractical and unfair.

Repeal of the ACA will also re-open the Medicare "donut hole" -- immediately removing the 50 percent discount on prescription drugs that millions of seniors receive today. Seniors would once again be forced to pay out of pocket for important preventative services like mammograms, annual physicals, cervical cancer and colorectal cancer screenings, cholesterol tests, and flu shots. Repeal will also revoke the 12 additional years of solvency for the Medicare Trust Fund, harming America's seniors and taxpayers.