CONCORD, N.H. (AP) — The governor has come out against the Senate Republicans’ health care bill, saying it could force the state to make “severe cuts” to its Medicaid program.

Gov. Chris Sununu, a Republican in his first term, said in a letter to Senate Majority Leader Mitch McConnell that the bill would lead to cuts in eligibility, loss of coverage or significant increases in taxes. The state’s Democratic congressional delegation also opposes Republican legislation to overhaul former President Barack Obama’s health care law.

In particular, Sununu is unhappy with the Better Care Reconciliation Act’s reliance on a per-capita cap to decide how much federal Medicaid money would go to states, projecting New Hampshire could lose $1.4 billion over a decade.

“As with the House version, New Hampshire would be locked into per capita rates that would force the state to confront the hardest of choices: make severe cuts to its Medicaid program, such as ending eligibility categories or eliminating coverage of vital services, or both,” Sununu wrote. “We are further concerned that BCRA jeopardizes the investment New Hampshire made in its Medicaid expansion. Our Medicaid expansion has been one of the primary tools to combat our opioid crisis.”

The program caters to low-income residents and serves 130,000 people in New Hampshire, including 90,000 children and 20,000 senior citizens and those with disabilities.

Sununu said he found some things to like about the Senate bill, including the flexibility given to states and the fact it maintains preexisting-condition protections. He also applauded an option in Medicaid to provide coverage for limited stays in mental health facilities.

Sununu is the latest Republican governor to raise concerns about the bill, with New Jersey Gov. Chris Christie expressing reservations about proposed changes in Medicaid and Ohio Gov. John Kasich calling the bill’s Medicaid cuts harmful to America’s most vulnerable citizens.

A vote on the bill was delayed Tuesday until after Congress’ July 4 recess, and that prompted several congressional Democrats in New Hampshire to renew their attacks on the legislation. They noted that the Congressional Budget Office said Monday the measure would leave 22 million more people uninsured by 2026 than Obama’s 2010 statute.

“The American people were shut out of negotiations on this disastrous legislation, and now, finally, there’s some indication that their concerns are being recognized by Republican leadership,” Sen. Jeanne Shaheen said. “But make no mistake, the threat this bill poses to the health and wellbeing of New Hampshire and the rest of the country is still very real. There are growing bipartisan calls for Republicans and Democrats to work together to improve health care for the American people — it’s long past time for these efforts to begin.”

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