Doug Hart with the Alliance for Retired Americans urges Sen. John McCain to vote against the latest ACA repeal legislation.

Opponents of the Republican effort to repeal the Affordable Care Act are ratcheting up the pressure on U.S. Sen. John McCain to vote no.

On Wednesday, a handful of progressive groups and Democratic lawmakers gathered on the Capitol lawn in Phoenix to decry the latest ACA replacement legislation, known as the Graham-Cassidy plan.

“This bill is going to kill seniors. It’s going to kill fellow Americans. I can’t imagine the kind of people that would vote for such a bill,” Doug Hart with the Alliance for Retired Americans said.

“I think John McCain had a twinge of conscience last time,” Hart said, referring to McCain’s surprise vote to sink the so-called “skinny repeal." “We pray he has the same twinge of conscience this time.”

These gatherings have become almost routine in recent months with each attempt to repeal the health care law. And in many ways, the concerns remain the same.

“If you are in a pre-existing condition category, you will find yourself without insurance or having to pay a very high premium,” Arizona Democratic Congressman Ruben Gallego said. “Of all the states that are going to lose because of this bill, Arizona is going to be one of the top,” Gallego said.

The legislation gives states block grants to help people buy coverage. It also lets states waive many of the consumer protections in the ACA and eliminates the subsidies for consumers. The bill’s sponsor, however, argues people with pre-existing conditions will be OK because states must still ensure people have access to affordable and adequate insurance.

The Congressional Budget Office has not yet released a score of the legislation and Arizona health officials are still crunching the numbers.

Instead of an open-ended funding stream, the Medicaid program would be capped. An analysis from Avalere finds that Arizona would lose about $11 billion in overall federal funding between 2020 and 2026. Much of that comes from cuts to Medicaid, including a phase-out of the extra funding tied to the ACA’s expansion of the program. More than 400,000 people are covered in Arizona because of the expansion. 

Another analyis from the AARP Public Policy Institute estimates Arizona's Medicaid could lose anywhere from $26 billion to $61 billion by 2036.

Arizona Gov. Doug Ducey has come out in support of the bill alongside Sen. Jeff Flake.

McCain, a key vote, has repeatedly said he would like any ACA replacement to go through the regular legislative process but has not yet said what he will do.