Local cardiologist Dr. Jun-Yang Lou said he sees firsthand what happens when people without health insurance forgo preventive care.

A few weeks shy of her 65th birthday — when she would have qualified for Medicare for senior citizens — a spirited, independent patient who had not enrolled in government-subsidized health insurance suffered a sudden tear in her aorta. The tear in her body's main artery might have been prevented if she had received treatment for her high blood pressure, Lou told protesters at a Tuesday rally in Medford.

"She's now stuck with immense hospital bills," he said.

Lou was one of the speakers at the rally that started at the Jackson County Courthouse, moved to the downtown Medford office of U.S. Rep. Greg Walden, R-Hood River, and ended at Vogel Plaza. Hundreds of protesters gathered in opposition to the House Republicans' American Health Care Act, which would repeal and replace the Affordable Care Act.

In a report released Monday, the nonpartisan Congressional Budget Office estimated the Republican replacement would cause 24 million people to lose health insurance coverage by 2026. During that same time period, the new plan would save the federal government $337 billion.

If passed as is, the Republican plan would cause 14 million people to lose coverage in 2018.

Under the Affordable Care Act, 25,173 Jackson County residents gained health insurance subsidized mainly by the federal government, with a portion paid by the state of Oregon, according to the Oregon Health Authority.

Almost one in three Jackson County residents is now on the Oregon Health Plan.

The number of uninsured Jackson County residents dropped to 4.3 percent. In neighboring Josephine County, which has more low-income people and added 12,463 to ACA rolls, the percentage of uninsured residents dropped to 1 percent, according to Oregon Health & Science University.

While attention so far has focused on insurance coverage losses and cost savings from the Republican plan, Lou said the plan cuts a broad array of preventive services, which are cheaper in the long run than paying for catastrophic medical problems.

Spending would be reduced on programs for Alzheimer's disease prevention and education, breastfeeding promotion, diabetes prevention, smoking cessation, immunizations, lead poisoning programs and more, he said.

"We spend far less on preventative care than we do for catastrophic care," Lou said.

Family nurse practitioner Lauri Hoagland, who works for La Clinica, said she has worked in health care for more than 30 years. Before the ACA, people would delay treatment.

"A lot of people did not come in until it was almost too late," Hoagland said.

She recalled one patient who resisted going to the hospital because she couldn't afford the ambulance bill. She finally got treatment in the hospital's intensive care unit and survived.

Under the Republican plan, insurance premiums would cost less for young adults and more for older adults. Current law allows insurance companies to charge older people three times more than younger people, but the new plan would allow older people to be charged five times more, according to the CBO.

AARP, which represents people 50 and older, says older Americans would pay thousands of dollars more for health insurance, even when new tax credits are factored in.

New tax credits would range from $2,000 to $4,000, with credits increasing by age.

"Under the legislation, premiums for older people could be five times larger than those for younger people in many states, but the size of the tax credits for older people would only be twice the size of credits for younger people," the CBO said.

The plan would eliminate the mandate that people have insurance and would reduce requirements on companies to provide employer-based insurance. About 2 million fewer people would have workplace-based coverage next year, and that number would grow to 7 million in 2026, the CBO says.

The National Federation of Independent Business issued a statement in support of the Republican plan, saying ACA requirements on employers have increased costs, limited choices and smothered job creation.

"There's a lot more work to be done in order to make the health care system affordable, flexible and predictable, but the American Health Care Act is a necessary first step," the business group said.

According to the federation, the high cost of health care has been the top concern of small business owners for the past 30 years.

The American Medical Association and a host of other health care groups have come out against the Republican plan.

Insurance plans would not have to cover as many services, which could reduce insurance premium costs but increase consumers' out-of-pocket costs, the CBO said.

Medford resident Mike Whitfield, who was not part of the rally against the Republican plan, said protesters should at least give the Republicans a chance and support efforts to rein in out-of-control health care costs. He was with a smaller nonpartisan group holding American flags and banners saying, "United We Stand — Divided We Fall."

"No doubt about it, the health care system is broken. My biggest complaint with Obamacare is you penalize people for something they can't afford," Whitfield said, referring to penalties people face for going without insurance.

Whitfield said his wife was recently prescribed a 10-day supply of medication that cost $1,200.

He noted America is already trillions of dollars in debt.

The national debt has surpassed $19.9 trillion — or more than $61,000 per citizen, according to the U.S. National Debt Clock website.

The Republican health care plan would do away with federal and state websites that allow people to shop for subsidized insurance. Existing tax credits and cost-sharing subsidies would be eliminated in 2020.

It would also eliminate federal funding for Planned Parenthood for one year, saving $178 million this year, but costing $21 million to cover childbirth expenses from more unplanned pregnancies, the CBO said.

Federal law already prohibits federal funding of abortion.

Planned Parenthood supporters said abortion accounts for only a fraction of its services, and the funding ban would reduce access to contraceptives, cancer screenings, sexually transmitted disease testing, vasectomies and more.

— Reach staff reporter Vickie Aldous at 541-776-4486 or valdous@mailtribune.com. Follow her on twitter at www.twitter.com/VickieAldous.