A legislative panel in Kansas is recommending that people living with hepatitis C virus (HCV) who drink alcohol or do not adhere to their treatments should lose their Medicaid coverage as a consequence, The Associated Press reports.

New guidelines from the KanCare Oversight Committee, run by the state’s health and human services department, say that they will now try to use “step therapy”—which requires people covered by Medicaid to try cheaper therapies first, and only receive more expensive treatments if the first line fails. However, state and federal law forbid that practice.

State Senator Jim Denning (R–Overland Park) suggested the proposal, according to the Wichita Eagle. Many Republicans on the panel agreed, saying the state should not have to pay for an HCV-positive person who does not follow their doctor’s orders. Two Democrats voted against the idea, calling it a “death sentence” for many people living with the virus.