As Congress grapples with the implications of the House Republicans' American Health Care Act (AHCA), Pennsylvania advocates are hunkering down and preparing for a prolonged battle.

On Thursday, Philadelphia Mayor Jim Kenney convened a panel of 13 elected women leaders to hear from experts and members of the public on how repealing the Affordable Care Act (ACA) could impact the local community.

“The AHCA is the worst women’s health legislation in a generation,” said Dayle Steinberg, president and CEO of Planned Parenthood Southeastern Pennsylvania.

A recent analysis by the Congressional Budget Office estimated that the AHCA would leave approximately 23 million more Americans without health coverage.

People with pre-existing medical conditions and others who were seriously ill "would ultimately be unable to purchase" comprehensive coverage at premiums comparable to today's prices, "if they could purchase at all," the report said.

The report also said older people with lower incomes would disproportionately lose coverage. Over half of those becoming uninsured, 14 million people would come from the bill's $834 billion in cuts to Medicaid, which provides health coverage to poor and disabled people.

“The proposal that is on the table right now is not only greedy, it’s mean-spirited and insulting in terms of how these people in government feel about women and children, poor people and people who do not have access to affordable healthcare,” said Jovida Hill, executive director of the Philadelphia Commission for Women.

Katharine Miller was still covered through her parents’ health insurance when her menstrual cycle became unbearable. She spent her 26th birthday undergoing surgery for uterine polyps that caused to her to miss several days of work every month.

One day after the surgery, she lost health insurance under former the ACA. Miller thought her doctor would continue to treat her despite the lapse in coverage.

She was wrong.

“As soon as I told them my health insurance had changed, they told me they couldn’t see me anymore,” she said.

Despite her college degree, Miller could not find full-time work in the years following graduation. She struggled to pay bills and could not afford her longtime doctor. Broke, Miller qualified for Medicaid, which has been expanded under the ACA.

Hoping to see her doctor once again, Miller contacted the office only to be turned away. They did not accept Medicaid.

“It didn’t matter that I had been seeing the same doctor for five years. It didn’t matter that they were the practice that diagnosed my condition, that performed my surgery. None of that mattered,” she said.

Eventually Miller turned to Planned Parenthood for follow-up care. She was able to receive a prescription for birth control — not to prevent pregnancy but to prevent the uterine polyps from coming back.

Without Medicaid, that prescription would have cost her $24 per month, Miller said. It would have been the difference between a monthly bus pass and taking her medication. She credits Planned Parenthood with providing a place to seek medical help without the extra burden of being judged.

“It was the first time … in my life that I had a conversation with an adult about my reproductive healthcare... It was the first time I had a conversation about birth control. It was the first time I had a conversation about safe sex,” Miller said of her first time visiting Planned Parenthood when she was 18 years old.

Planned Parenthood stands to lose funding under the AHCA, which could directly impact the 40 percent of patients in Pennsylvania who are on Medicaid, Steinberg said. Her organization does not have contingency plans in place should Congress cut dollars from Planned Parenthood.

“It’s basically the government telling patients where they can and cannot get health care,” Steinberg said. “We’re going to continue to provide services no matter what, but it’s going to be very difficult.”

CORRECTION (Jan. 16, 2018, 1:50 p.m. ET): This story has been updated to correct the spelling of Katharine Miller's name and to clarify the medical care she received.