Disability advocates are decrying a renewed drive to overhaul the nation’s health care system that they say would fundamentally alter Medicaid and jeopardize home and community-based services.

Less than two months after a Republican plan to repeal and replace the Affordable Care Act failed in dramatic fashion, a new effort is underway in the U.S. Senate to upend the Obama-era law.

A proposal spearheaded by Sens. Lindsey Graham, R-S.C., Bill Cassidy, R-La., Dean Heller, R-Nev., and Ron Johnson, R-Wis., was introduced last week and it appears to be gaining steam.

The move comes as Republicans face a deadline. Under a procedural maneuver, they could pass a bill to change federal health care law with only a simple majority by Sept. 30, but after that, 60 votes would be needed.

With time running short, the Senate may be headed for a health care face-off the last week of September. And that prospect has disability advocates alarmed.

“While this piece of legislation has a new title and makes new promises, it is more of the same threats to Medicaid and those who rely on it for a life in the community,” said Peter Berns, CEO of The Arc.

The proposal would give states significantly more discretion over health care, potentially compromising protections for those with pre-existing conditions, advocates said. And much like previous Republican proposals, the plan would impose first-ever caps on federal funding for Medicaid.

Currently, Medicaid operates as an entitlement with states receiving matching grants from the federal government to cover the cost of anyone who’s eligible. Under the Republican proposal, states would instead receive a fixed amount of money for each beneficiary regardless of the true cost of their care.

The Congressional Budget Office said it expects to have a preliminary assessment of the latest bill by early next week. However, the budget office determined earlier this year that similar proposals would lead to at least $700 billion less in federal Medicaid spending by 2026.

If Medicaid caps are instituted, advocates say that fewer dollars would likely lead states to chop optional offerings like home and community-based services for people with disabilities.

The Consortium for Citizens with Disabilities, The Arc and the Autistic Self Advocacy Network are joining with other groups to hold a rally Tuesday afternoon on Capitol Hill with Senate Minority Leader Chuck Schumer, D-N.Y., to protest the health care proposal.

Meanwhile, advocacy groups are issuing regular action alerts urging members to call their senators.

“We’re urging our grassroots to mobilize with the same strength we saw this summer,” said Julia Bascom, executive director of the Autistic Self Advocacy Network. “We can defeat this — again — but it’s going to take another huge push.”

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