PHILADELPHIA (CBS) — As Senate Republicans try to settle on a final health care bill for a vote later this week, a new report published Monday in a major medical journal says not having health insurance increases a patient’s risk of death.

People like Fred Zorn, who got coverage through the Obamacare exchange, worry they will no longer be insured. Zorn has a pre-existing condition, inflammatory bowel disease.

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“When I didn’t have insurance, I was so much more stressed about the fact that I didn’t have backup behind me that it actually caused me to have worse symptoms,” he said.

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The report published today in the Annals of Internal Medicine says having health insurance reduces the risk of death.

“People get to see the doctor or nurse practitioner and get their health problems taken care of,” Dr. David Himmelstein, one of the article’s authors, said. “If you don’t have health insurance, you’re unlikely to get treatment for your diabetes or your depression.”

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The study estimates about one person will die for every 800 people without health insurance in a year.

Zorn and his wife Sarah Zorn got health insurance through the Affordable Care Act. While Republicans insist their new plan will cover pre-existing conditions and will lower insurance premiums, the Zorns are concerned about the future.

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“I’ve never been as scared as I am right now because I know what we would lose now,” Sarah said. The couple is also worried about the cost of Fred’s medications, which run tens of thousands of dollars each month.

On Monday, the nation’s largest doctors’ group, The American Medical Association came out strongly against the Senate Republican health care bill. They say low- and middle-income patients will be exposed to higher costs. The AMA says the bill violates their oath: “First, do no harm.”

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The Annals of Internal Medicine, the flagship journal of the American College of Physicians, published the report with an abstract available here.

Stephanie Stahl