Virginia Sen. Tim Kaine on Monday told students in Roanoke that he doesn’t care whether it’s called replace, repair or reform, just as long as something immediately follows repeal of the Affordable Care Act and offers access to all.

Kaine, a Democrat, was recently appointed to the Senate Health, Education, Labor and Pensions Committee and has been traveling Virginia to gather views of people who work in health care. On Monday, he toured labs at Jefferson College of Health Sciences and then met with a packed room of students to talk about the future of health care.

“The thing we are most engaged with right now in Congress is a battle about whether the Affordable Care Act will be repealed or whether it will be fixed. That is a massive debate. And the answer to that debate is going to shape all of your careers,” Kaine said.

He views his first task as convincing his Senate colleagues of the danger in repealing the Affordable Care Act without an immediate replacement.

“Basically, that was a jump-off-the-cliff-and-figure-out-how-to-land-in-midair plan,” he said. “In Congress, we shouldn’t be creating uncertainty — sadly we do that pretty well. We should try to create more certainty.”

Repeal without replacement would affect 30 million Americans, disrupt the insurance and health care industries and negatively affect the economy, Kaine said.

Since passage of the Affordable Care Act in 2010 and throughout former President Barack Obama’s terms, congressional Republicans repeatedly attempted to repeal it. Now with President Donald Trump also calling for quick repeal, the GOP is tasked with designing a replacement plan, but there appears to be little agreement.

Republicans met last week for a retreat in Philadelphia, and a tape leaked to news outlets showed members unsure how to replace the act without clear direction from Trump, who has said no one will lose coverage or pay more.

“Folks are saying the replacement plans will not make us worse off. They will hopefully maintain coverage and make us better,” Kaine said. “We’ll have to put any plan they propose under a microscope to see if that is the case.”

Kaine said his idea is to bring patients, providers, insurers and hospital leaders to the table and have them propose changes that would make the Affordable Care Act better.

Students offered a couple of suggestions.

One said she found purchasing a plan through the marketplace exchanges to be arduous. “I personally struggle and I have a lot of education. I can only guess how the marginalized population does,” she said.

The exchanges offer a way for people without workplace insurance to purchase plans; most qualify for government subsidies to help pay the premiums.

But students without jobs or with low-paying ones can’t take advantage of the exchanges because their income is too low.

Many students are still covered under their parents’ plans, as the Affordable Care Act made it possible for young adults to stay on the plans through age 25.

“The ACA has been fantastic for coverage under our parents,” said Mia McDonald, a second-year physician assistant student and president of the PA Class of 2017.

But with many health care professions requiring master’s and doctorate degrees, students are aging out of their parents’ plans before graduation.

“We have a very rigorous program, so many of us can’t work. We don’t qualify for the marketplace,” she said.

Kaine said one of his sons will face that situation next year. Kaine said he also knows what it is like to be turned down for insurance. After he left the governor’s office, he had to buy private insurance for his family and found that a pre-existing condition made it hard to find a plan to cover all of them.

While attention is focused on redesigning a health care system, Kaine asked the students to shift their focus to health promotion and remember throughout their careers to be health educators.

“Here’s the challenge we have in this country. We have a fantastic health care system for treating illnesses, accidents and injuries. We train the best professionals. But we don’t have great health,” he said. “There’s no way you’re going to create a health care system that you’re going to like the outcomes, either the health outcomes or the cost, if a population is becoming less and less healthy.”

This article originally appeared in The Roanoke Times.