People with diabetes, asthma, hypertension, depression, anxiety and other chronic conditions, including heart disease and cancer, have more problems accessing affordable care than other Americans, according to a report from the American Medical Association.

The AMA study, published Thursday in The Lancet, also found that people with chronic conditions such as diabetes, high blood pressure and high cholesterol have worse access to care, compared with people who do not have those conditions.

“A growing body of evidence suggests that a lack of affordable and effective health care may be an important driver of disparities in health and wellbeing,” said AMA President David Cutler.

“These findings are further evidence that we need to address the disparities in access to health care and better manage the impact of these health disparities on individuals, families and communities.”

The AMA report comes as President Donald Trump is considering repealing the Affordable Care Act, or Obamacare, a landmark health care law passed by Congress in 2010.

It also comes amid a backlash against health care providers, particularly hospitals, who were expected to bear a greater burden under the new law, as some insurance companies have announced they would leave the health care marketplaces under a new Republican proposal to overhaul the healthcare system.

The Republican plan also aims to reduce Medicaid spending, which has risen to $11.4 billion per month from $18.9 billion a year ago.

Trump has proposed scrapping the individual mandate, a requirement that most Americans pay taxes on their own medical care and pay for coverage in a private health plan, a policy known as a Cadillac tax.

Cutler said he believes Trump’s plan will be “very harmful to Americans who need access to affordable and quality health care.”

“The ACA was designed to ensure that we can all be insured and that there is a level playing field,” Cutler said.

“We need to make sure that every American has access to quality health coverage.”

The study also found the prevalence of pre-existing conditions among people with diabetes and hypertension, asthma and depression is higher in rural areas and those with pre-exisiting conditions, compared to urban areas.

In terms of health care disparities among the uninsured, people with income below $23,400 per year were more likely to be denied care than those with higher incomes.

In addition, the uninsured were more often in the “high-risk” category compared to those with incomes of $70,000 per year or more.

People who have asthma, diabetes, hypertension and depression are more likely than those without these conditions to have serious medical conditions, such as heart disease or cancer.

Cutler called on Trump to “find ways to help ensure that all Americans can access the health benefits that they need.”