U.S. Sen. Tammy Duckworth (D-Ill.) and Dick Durbin (D-Ill.) urged Gov. Bruce Rauner to oppose a repeal of the Affordable Care Act in a letter sent Tuesday.

In the letter, the senators point to the potential economic and health impacts of a repeal of the act. The letter cites a report from the Illinois Hospital and Health Association, which estimates a repeal without a similar replacement would create potential losses of $11.6 to 13.1 billion in annual economic activity. The lost in activity could result in job losses between 84,000 to 95,000, the association reported.

In the letter, the senators said 1.2 million people in Illinois would lose their health insurance in 2019 if the act is repealed.

“We strongly urge you to reconsider your position towards these destructive Republican plans, and to stand firmly with Illinoisans against efforts to repeal the ACA without an adequate replacement plan in place to protect the coverage gains, affordability, benefits, and consumer protections that Illinoisans currently enjoy,” the senators wrote.

Senate Republicans moved to repeal the Affordable Care Act last month by passing a framework budget that limits the ability of Democrats to filibuster a repeal of the law. President Donald Trump has said he will push for the repeal of the ACA and the replacement of it with another health care law.

The two also criticized a letter Jennifer Hammer, acting Director of Insurance for the Rauner administration, sent to Congress in December per Republican lawmakers’ request.

In the letter, Hammer said, “major structural flaws in the ACA have forced higher insurance rates and separated families from trusted physicians and hospitals.”

The act has also raised premiums and limited choice of insurers, Hammer wrote.

Congressional Republicans should consider “ramifications of proposed changes” to individuals on Medicaid, the senators wrote.

Durbin and Duckworth said they were “disappointed” the letter “failed to provide any information regarding the potential fallout or benefit from repealing the ACA.” The senators pointed to letters sent by other Republican governors that warned against repealing the act.

The senators said they supported the administration for applying a Medicaid demonstration waiver to improve the delivery of behavioral health care services for Illinois residents. Such a waiver would be threatened under a repeal of the ACA, they said.

“We cannot ignore the reality that Congressional Republican plans to restructure the Medicaid program toward a block grant or per-capita cap could obviate any potential gains from this 1115 waiver because of the deep funding cuts and benefit reductions that would certainly occur,” they said in the letter.

Both Durbin and Duckworth said in the letter they would work to “reform and improve” the ACA for Illinois residents, but warned a repeal without a replacement “terminates all of the important and life-saving benefits we have achieved in recent years.”

Rauner spokesperson Catherine Kelly said in a statement the governor would “continue to advocate for the best interest of the people of Illinois.”

“Senator Durbin was a leading proponent of Obamacare, which resulted in skyrocketing health care costs on millions of Americans,” she said. “As Senators Durbin and Duckworth well know, our administration has urged Congress to take a thoughtful approach to any new health care changes.”

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