(AP) U.S. Rep. Matt Cartwright advocated for the continuation of the Affordable Care Act and Medicaid expansion Saturday at the former Saint Catherine Medical Center.

“I say let’s keep the ACA. Let’s preserve the all-important Medicaid expansion and let’s prevent fine community hospitals like Saint Catherine’s from closing,” Cartwright, D-17, said.

The medical center closed in April 2012 due to financial problems. He said the hospital suffered financially because it had to absorb costs from those who were uninsured or underinsured.

“Saint Catherine’s had a storied 130-year-history. It was a pillar of medical care in the anthracite coal region since the 1880s and, in fact, it was the first hospital in Schuylkill County,” he said.

Cartwright spoke about the ACA’s importance to thousands of people and the dire circumstances people could be in if they didn’t have insurance for things such as pre-existing conditions.

“There are 129 million Americans with pre-existing conditions. All of them are nervous about what will come if we do a repeal without a replacement,” he said.

He said he realizes the ACA is not perfect.

“I have said that ever since I am in public life that I expect to be tinkering with the Affordable Care Act as long as I am in the Congress, and it’s a work in progress, the ACA. I am committed to fighting every day to improving it and making it work for Americans. In other words, keep it and make it better,” Cartwright said.

Abolishing it without a reasonable alternative in place is foolish, he said.

“President (Donald) Trump ran a campaign promising to repeal and replace the Affordable Care Act and right now Republicans in Congress are looking to carry out that mission,” Cartwright said.

The ACA has made life better for thousands of people, he said.

“Today under the ACA, about 20 million Americans have gained access to health care through various coverage provisions, including subsidized coverage through the exchanges and the historic Medicaid expansion. When Medicaid was expanded in Pennsylvania in 2015, hundreds of thousands in our state became newly eligible for enrollment. As of Jan. 20 of this year, over 700,000 Pennsylvanian’s were enrolled in Medicaid. That’s an increase over 300,000 since the Medicaid expansion,” he said

Ted Dallas, secretary of the state Department of Human Services, said previously about 21 percent of residents are covered by Medicaid. Enrollment in Medicaid increased between 14 and 28 percent per county during the first year of Medicaid expansion.

Cartwright cautioned what could happen if it were removed without a replacement.

“One of my greatest concerns is that working families would bear the brunt of a repeal by losing insurance and seeing premiums rise dramatically. The nonpartisan Congressional Budget Office found that it would result in the number of uninsured Americans surging by 18 million the first year and climbing to 32 million in 2026. Additionally, Americans in the individual insurance market would see their premiums rise 20 to 25 percent in the first year after a repeal, then doubling in 2026,” he said.

Statewide, Cartwright said 644,000 people who are presently covered since the law took effect could lose their coverage if it goes away.

“This threat is very real,” he said.

The Urban Institute, an organization based in Washington, D.C., said 62,000 people in Schuylkill, Carbon, Lehigh and Northampton counties would be without coverage in 2019.

“No one in our country should live in fear of getting sick and not being able to afford the care they need. No one should have to agonize over whether to pay their medical bills or their mortgage. Providing the peace of mind that health insurance coverage brings should not be a divisive issue in our society,” Cartwright said.

For those who think the ACA might not work or be a detriment for some businesses, he said that smaller businesses are eligible for tax credits to compensate for employee coverage.

“On a macro level, don’t ever forget if people are covered they are going to go to the doctor. They are not going to wait until problems fester and get worse and worse and worse and then have to show up at the emergency room,” Cartwright said.