It’s hard to believe that less than two months after the last health care repeal bill was defeated in a late-night session on the Senate floor, millions are once again at risk of losing health coverage. But it’s true. The Senate is taking another crack at passing a health care repeal bill ahead of a key procedural deadline on Sept. 30 (after that, 60 votes would be needed to pass a bill rather than 50).

The latest bill, dubbed Graham-Cassidy after its two lead sponsors, is every bit as devastating as the bills that were introduced this summer, particularly for women and people with disabilities. In fact, in some ways, it’s even worse.

While we don’t know the exact numbers because it’s being jammed through so fast that the CBO won’t be able to complete a full analysis by next week, there’s no doubt that it will cause tens of millions of people to lose insurance coverage altogether.

And Graham-Cassidy is gaining steam. That’s why it’s absolutely critical that your senators hear from you now. Here’s what you need to know:

This bill is a catastrophe for people with disabilities.

Graham-Cassidy severely damages the programs and policies that people with disabilities rely on to stay healthy and to live freely. For example, the bill:

Cuts and caps Medicaid. The bill fundamentally alters the Medicaid program by limiting federal financing through a per capita cap and cutting billions from the program. For millions of people with disabilities, Medicaid is a lifeline. They depend on the services and supports that Medicaid provides to get out of bed, go to work, and live in the community instead of an institution. It is no exaggeration to say that the lives and liberty of people with disabilities depend on a strong Medicaid program.

Ends the Medicaid expansion. It would end the Medicaid expansion and instead provide states with block grants (that disappear in 2026), forcing states to throw millions of people off of coverage. The Medicaid expansion has allowed individuals with disabilities, especially those with mental health needs, to access much needed care.

Allow pre-existing condition discrimination. It would allow states to waive the Affordable Care Act’s prohibition against charging higher premiums based on health status. This means that insurance companies, depending on state law, could charge significantly more for an insurance policy if an individual has a pre-existing condition like autism, depression, bipolar disease, etc. People with disabilities would certainly lose health insurance coverage because it would no longer be affordable.

This bill is the worst yet for women’s health.

Graham- Cassidy is an all-out assault on women’s health and reproductive rights. It would make it more difficult for women to prevent unintended pregnancy, to have healthy pregnancies, or to raise healthy families. Specifically, the bill would:

Prevent patients from getting care at Planned Parenthood. The bill would block Medicaid patients from seeking care at Planned Parenthood health centers, denying many low-income people lifesaving preventive care like cancer screenings, tests and treatment for sexually transmitted infections, and birth control. Many Planned Parenthood health centers, which more than 2 million people rely on for care every year, would be forced to close their doors, leaving a void that could not be filled by community health centers.

Gut protections for maternity care and other Essential Health Benefits. Under Graham-Cassidy, states could give insurance companies free rein to exclude coverage for maternity care, newborn care, mental health and substance use treatment, prescription drugs, and more. This would mean women would have to pay extra for maternity coverage, which was often excluded from individual plans before the ACA.

Disproportionately hurt women with its severe cuts to Medicaid. Women make up the majority of Medicaid enrollees, with nearly 40 million relying on the program. Medicaid covers 20 percent of women of reproductive age, enabling them to decide when, whether, and how to start families. It covers 75 percent of publicly funded family planning services and approximately half of all births in the U.S. It would be especially harmful to women of color who are enrolled in Medicaid at higher rates.

Expand harmful abortion coverage restrictions. The bill would effectively eliminate abortion coverage from the private insurance market by banning the use of tax credits to purchase insurance policies that cover abortion beyond cases of life endangerment, rape, or incest. It would even restrict women’s ability to use health savings accounts to which they’ve contributed to access abortion care. Denials of abortion coverage can have disastrous consequences for women who are already struggling to get by.

The bottom line is that Graham-Cassidy is devastating to the health, life and liberty of millions of people across the country. We must rise up again to defeat this legislation. Tell your senators to vote no.