As the Senate rushes toward a potential vote next week to repeal the Affordable Care Act (ACA, or Obamacare), harm reduction advocates argue that the latest GOP plans to reduce health care spending and cut back Medicaid would be detrimental to their fight against the nation’s ongoing opioid crisis, reports.

While Republican lawmakers still don’t know exactly which legislation they will be considering next week, health care analysts estimate that any of the plans pitched by GOP lawmakers thus far could leave anywhere between 22 million and 32 million Americans without health insurance. Some GOP leaders are currently suggesting a bill to repeal and replace the current law, while others say they may be voting to simply repeal major planks of the 2010 health care law with no replacement.

The latest “repeal and replace” plan, offered by Senate Majority Leader Mitch McConnell (R–Ky.) earlier this month, does offer an extra $5 billion dollars over the next 10 years to target opioid addiction — likely in an attempt to woo moderates in states heavily affected by the nation’s ongoing heroin crisis. But many harm reduction advocates say the grant money would be effective only if people suffering from substance abuse disorders could still also get the other health care services Medicaid pays for.

For instance, a North Philadelphia methadone clinic owner interviewed by lamented that if Republican health care proposals in Congress cut back Medicaid funding, states like Pennsylvania would likely have to take cost-saving steps, such as limiting the duration of methadone maintenance, putting many people addicted to opioids at risk of a relapse.

Opponents of the provision also say the billions of dollars in additional funding do not account for how people with a history of injection drug use will be able to afford to treat syndemic, or linked, illnesses, such as hepatitis C virus (HCV), without long-term insurance coverage.

Meanwhile, the lack of details and analysis about the GOP’s plans are alarming patient advocates, physician groups and other health care workers across the country. A coalition of patient groups, including the American Diabetes Association, the March of Dimes, the American Lung Association and the advocacy arm of the American Cancer Society, signed a joint statement this week pleading with Senate Republicans to stop rushing to push through any health care legislation without taking into account its long-term effects.