In the early hours of Friday, July 28, an effort to repeal former President Obama’s Affordable Care Act collapsed. Late Thursday, as concerned citizens across the country gradually gave up the wait and went to sleep, it looked increasingly likely that the “skinny repeal”—an unpopular measure to repeal one key component of the ACA and give the bill to the House of Representatives—would pass. However, in a stunning moment, Republican Senator John McCain voted “no” on the measure. In doing so, his vote joined expected “no” votes from Republican Senators Susan Collins and Lisa Murkowski, as well as the entire Democratic caucus, to end this latest effort to destroy a law that has helped millions of Americans gain health coverage.

The ACA has been particularly beneficial to West Virginia, yet one notable Republican failed to join McCain, Collins, and Murkowski in standing against the bill: West Virginia Senator Shelley Moore Capito. Recently, Capito was one of a handful of Republicans in the national spotlight because of her hesitation in supporting the repeal. On July 18, she announced her opposition to repealing the ACA without a replacement plan, explaining that she “did not come to Washington to hurt people.” But at the moment of truth, when actions outweighed words, Senator Capito voted “yes” on the skinny repeal, along with most of her party.

Capito was correct to suggest that repealing the ACA would hurt people. The ACA includes provisions that assist low income and working class families, women, seniors, people with disabilities, and those facing addiction.  It also helps to address the health care disparities in marginalized communities.  Repealing the ACA would significantly hurt people from her state. In some ways, President Obama’s plan helps West Virginians just like it helps Americans elsewhere: for example, it prohibits insurance companies’ cruel practice of denying health care coverage for people with “pre-existing conditions.” But certain provisions of the ACA have had a particularly dramatic effect in the Mountain State.  For example, it drastically expanded Medicaid to allow working people who couldn’t afford insurance to participate, with approximately 200,000 West Virginians enrolling in the program. It also provides help in fighting problems important to Appalachians, including opioid addiction and black lung disease. Health care should be a right to all citizens, and West Virginia, where high poverty rates have a significant toll on major health issues, needs Senators who will fight for that right.

The “skinny repeal” didn’t seek to take away everything from the ACA: although it would still leave 15 million Americans without insurance, it didn’t remove the Medicaid expansion. But in voting for it, Capito almost ensured it would be passed on to the House and put under the control of Representative Paul Ryan, who made slashing Medicaid a priority this past spring. Thanks to unified opposition from Democrats and three key votes from Republican Senators, that didn’t happen. The ACA is safe for now, but repeal efforts are sure to continue. President Trump wants to simply let the ACA die of neglect. In Congress, Senator Lindsey Graham and Representative Mark Meadows are already working on new efforts to repeal the ACA.

The fight to protect West Virginians’ health care is not over, and there are three things you can do to help. First, call Senator Joe Manchin. Regardless of party affiliation, standing up against the Trump agenda is no easy political task for a Senator in a state that voted for the President by such a wide margin, and Manchin needs to know you support his continued efforts. Second, call Senator Capito and let her know that you’re disappointed in her vote that jeopardized the state of health care in West Virginia and put many West Virginians—particularly low-income families, people with disabilities, and women—at risk. Third, while you’re still on the phone with Capito’s office, insist that she begin to do what she promised and fight against efforts that hurt people: future efforts to repeal the ACA must be opposed, and she should listen to John McCain’s call for Republicans to work together with Democrats to improve the nation’s health care.