Republicans have one more trick up their sleeve to repeal the Affordable Care Act, and it is worse than the other bills that were rejected earlier this year.

It would dismantle the Affordable Care Act’s system of exchanges by ending subsidies, and it would end Medicaid expansion by 2020, leaving states to create a whole new mechanism to provide health insurance — with less money. Maine alone would lose more than $1 billion in federal Medicaid funding over the next decade if this new proposal became law. It would also decimate Medicaid by giving states a set amount of money, known as a block grant, without regard to the age or health of their populations. And it prohibits patients covered by the new state insurance plans from using Planned Parenthood for preventative care.

Like the Republican repeal bills before it, it was also crafted in secrecy, without hearings or input from Democrats.

It is so bad, it fails a test that one of its prime sponsors, Sen. Bill Cassidy, a Republican and physician from Louisiana, said any repeal measure must pass. After comedian Jimmy Kimmel spoke passionately about his young son and the heart surgery that was needed to correct a congenital defect, Cassidy said any health insurance overhaul he supported must pass the Kimmel Test.

“Would a child born with congenital heart disease be able to get everything she or he would need in the first year of life? I want it to pass the Jimmy Kimmel test,” Cassidy said in a May interview with CNN.

“I want to make sure … that if a child is born and has [a congenital defect] — that they would receive all the services even if they go over a certain amount,” Cassidy said. “So, simple answer, I want to make sure folks get the care they need.”

His bill, co-sponsored by Sen. Lindsey Graham, R-South Carolina, fails that test.

While the bill says pre-existing conditions must be covered, insurers could be allowed to charge much higher premiums to families like the Kimmels, with a history of high-cost care. States could also allow plans that do not cover essential health benefits, such as prescriptions and maternity care. Offering coverage that families and individuals cannot afford, and that may not cover many of the services they need, is an unnecessary step backward from what current law requires.

Despite these huge flaws, opponents of the Affordable Care Act, including Gov. Paul LePage, are demanding that Republicans fall in line and vote for the Cassidy-Graham bill. Sen. Susan Collins was one of three Republicans, along with John McCain and Lisa Murkowski, to vote against an Affordable Care Act repeal-and-replace bill in July that was thought to be the GOP’s last chance to undo the Obama-era health care act. Collins has expressed the same concerns — premium increases for older Americans and people with pre-existing conditions, deep Medicaid cuts — about the Cassidy-Graham bill.

In an email sent Sunday by the Maine Republican Party, LePage called on fellow Republicans to “ save the American health care system” by urging Sens. Collins and Angus King to vote for the Cassidy-Graham bill. Both senators have opposed the many GOP bills to repeal the Affordable Care Act and replace it with skimpier plans that would have left millions of people without insurance coverage.

For the same reasons, they are right to oppose this latest secretive attempt to gut the Affordable Care Act that will leave tens of millions of Americans without health insurance.

Collins, along with McCain, set the right standard in July when they called for a bipartisan approach to reforming the health care law, with hearings and expert testimony, which is the normal custom with legislation. The Senate Committee on Health, Education, Labor and Pensions is already holding hearings on bipartisan fixes to the Affordable Care Act.

Until there is a plan to improve the Affordable Care Act, not just repeal it to fulfill a political promise, the answer must be a “no” vote.