Republican leaders in Congress are working on plans to cut health benefits for tens of millions of people. The harms from these cuts are likely to have the biggest impact on women, both for their own health benefits and as they try to manage health care for their families.

Every major source of health coverage is now at risk under the Republican health plans. This includes individual coverage bought through the Affordable Care Act, workplace health plans, Medicaid benefits for people struggling to make ends meet, and Medicare for seniors and people with disabilities.

The ACA included important changes in the law requiring women to be treated fairly. Repealing the ACA outright, as Republican leaders say they want to do, could mean going back to the days when insurance companies could legally discriminate against women by charging them higher monthly premiums for individual coverage than men.

Repeal also could mean getting rid of protections requiring individual policies to cover pregnancy and pay for preventive services, like women’s well visits and birth control.

Republican leaders also are intent on slashing Medicaid by more than a half trillion dollars over 10 years, which will take health coverage away from millions of people and cut benefits for many others. This government health program for people struggling to make ends meet pays for one-half of all childbirths in the United States. It also covers the bill for more than three-in-five nursing home residents—a group made up disproportionately of older women who otherwise might have nowhere to go.

The fallout for women does not stop there. Women already are much more likely than men to be the ones navigating our complicated health care system for their families and dealing directly with its high costs. Women make about 80% of their family health care decisions, like deciding on the right care and how to pay for it. They also are far more likely than men to be caregivers, including for older adults, such as parents or spouses.

When the Republican health care cuts come, women are likely to have to deal with the consequences in their daily lives.

When they can no longer afford a private insurance policy or they get dropped from Medicaid, women likely will be the ones struggling to figure out how to get and pay for the care needed by a small child with an ear infection.

When Medicaid support is cut for seniors who need help so they can stay in their homes or who need to go to a nursing home, women are likely to be the family members who are figuring out how to care for an elderly parent with dementia.

When family paychecks are smaller or health benefits are cut back because Republicans have taxed workplace health plans, women are likely to be the ones at the doctor’s office figuring out how to pay the family health care bill.

Yes, women will be hit harder by the Republican health care cuts.

This blog originally appeared in aflcio.org on March 6, 2017.  Reprinted with permission.

Shaun O’Brien works for AFL-CIO.  His interests include retirement security and health care. Follow him on twitter @ShaunOBrien30.