WE DON'T KNOW whether to scream or sob. Many people who get insurance under the Affordable Care Act (that is, Obamacare) voted for Donald Trump - and now they are worried that they will lose their insurance if/when the ACA is repealed. (They will.)

About half of Trump voters, according to a poll before the election, opposed defunding Planned Parenthood. Some now are apprehensive that it might actually happen. (It will if, as he pledged, House Speaker Paul Ryan includes a provision in the ACA repeal that also would take away an approximately $450 million from the leading provider of women's health care.)

In early December, Planned Parenthood conducted four focus groups with Trump voters around the country (one of them in Harrisburg) to find out just what they were thinking - and it turned out that a lot of them simply hadn't been. They were stunned to learn that Trump is on record saying he supports cutting all government funding to the organization and even more surprised that Vice President-elect Mike Pence has led the war against birth control for many years.

While Planned Parenthood is the primary health-care provider for one in five American women, it also serves men and teens. No wonder 59 percent of Americans support the organization, according to a Gallup poll late last year.

As with an ACA repeal, if defunding goes forward, there would be little if anything to replace services. Pennsylvania has 32 clinics serving 90,000 patients, including 13 health centers in Southeastern Pennsylvania that provide care to 45,000 people. With defunding, about 40 percent of those people would be blocked from reimbursement from Medicaid, and there are not enough nearby providers ready or willing to provide that care. Consider this: When states such as Wisconsin and Texas defunded Planned Parenthood, there were significant drops in women receiving breast exams and Pap tests.

Make no mistake: This is about health care, not abortion. About 87 percent of Planned Parenthood's federal funding comes from Medicaid reimbursements. Just as with a private doctor, a patient receives a service such as test for a sexually transmitted disease or contraception, and the clinic bills Medicaid. Medicaid doesn't reimburse for abortions; abortion accounts for only 3 percent of Planned Parenthood's services and is paid from a different funding stream. The rest of federal funding for Planned Parenthood comes from Title X and is also not available to use for abortions.

Pennsylvania's U.S. Sen. Bob Casey, along with 36 other senators, all Democrats, signed a letter to Ryan expressing outrage at his plan. (Only a couple of Republican senators have expressed opposition to defunding Planned Parenthood. Sen. Pat Toomey? Of course not.)

So if Planned Parenthood is to continue its mission, it's an "all-hands-on-deck" moment, as one reproductive rights leader put it. The website, istandwithpp.org, includes several suggestions for individuals to take action, including phone calls, donations, volunteering and attending a community forum in Philadelphia on Wednesday, Jan. 25. Register at bit.ly/phillyactionforum to learn the location.

Since the election, medical professionals have reported a substantial uptick in women seeking contraception, for fear it soon will be unavailable. That is only a fraction of the number of women who will be left without health care if we do not act now.