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One-size-fits-all was one of the chief criticisms of the Affordable Care Act, also known as Obamacare. It seems the alternative proposed by the Trump administration has taken the same route -- only this time, affecting the poorest and oldest Americans. An AJC analysis of Kaiser Family Foundation data on the proposed American Health Care Act revealed that older Americans with the lowest incomes would be hit the hardest by the Republican replacement plan. (Datar, 3/17)

Massachusetts Republican Gov. Charlie Baker has a way to deal with the uncertainty surrounding his party's efforts to scrap Obamacare: Shift back to the pre-ACA days, when Romneycare reigned supreme. At its core, the system established in 2006 under former Gov. Mitt Romney was proto-Obamacare, mandating free health insurance for residents earning less than 150 percent of the federal poverty level while requiring employers with more than 10 full time workers to offer coverage. The 2010 federal health law superceded the state system, which by then had reduced the uninsured rate in the Bay State to 3 percent without raising health spending. (Dezenski, 3/17)

Illinois stands to lose an estimated $40 billion in federal money over the next decade under the Republican health care proposal being considered in Congress, experts told state lawmakers Thursday. ... The $40 billion projection is based on a report released this week by the Congressional Budget Office that said 24 million Americans would lose coverage by 2026 under the Republican plan, David Gross, senior vice president of government relations for the Illinois Health and Hospital Association, told lawmakers. The report said states could lose out on a possible $880 billion in federal funding over that same period. (BeMiller, 3/17)

Rhode Island may need to spend another $25 million to $30 million to keep 70,000 low-income adults from losing their Medicaid coverage under the House Republicans' plan to replace the Affordable Care Act in 2020, according [to] a preliminary analysis performed by health experts for The Providence Journal. And that's just in the first year. In 2021, the additional cost is projected to run between $65 million and $70 million — an expense, some experts say, the state would likely be unable or unwilling to absorb. (Arditi, 3/17)

Despite a national focus on the individual insurance markets, the Republican health plan being debated in Washington could have far more sweeping impact in Louisiana for other provisions that curb federal spending on Medicaid. That redesign is estimated to come with deep spending cuts. The implications would be major for Louisiana, where more than one-third of residents get health services through the Medicaid program, financed jointly by the state and federal government. (Deslatte, 3/19)

Detroit mother Vanessa Raices, 42, said she doesn’t know the ins and outs of what is happening with health care in Washington, D.C., but she knows enough to be worried. Health care for Raices and one of her four children is covered under Michigan’s Medicaid program. That coverage could change dramatically under the GOP health plan under debate by Congress. ... The program has deep roots in Michigan, where Medicaid provides health coverage for nearly 2.5 million people. The proposed changes would touch every community in the state, from urban centers in the southeast to the rural counties of northern lower Michigan and the Upper Peninsula. (Bouffard, 3/20)

Half of Denver Health’s patients are on Medicaid, meaning government dollars play a major role in the safety-net hospital’s budget. Already this year, Denver Health is trying to trim $48 million from its budget because of expected cuts to the hospital provider fee, a complicated mechanism to pay back hospitals for taking in poor and low-income patients that has also become embroiled in state Capitol budget fights. But the bigger threat, Denver Health leaders say, could come if Congress passes the American Health Care Act, the Republican-backed plan to replace Obamacare and overhaul how Medicaid works. Peg Burnette, Denver Health’s chief financial officer, said the bill could mean a revenue hit in 2020 — when the bill’s more significant Medicaid provisions kick in — of between $50 million and $85 million. (Ingold, 3/18)

How many older Floridians with Affordable Care Act coverage would see their premiums rise under the Republican replacement plan? About 454,000, according to a new analysis by AARP. Low-income people in their 60s would be hardest hit, the analysis found. For some, the proposal under consideration in Congress could mean an annual tax credit reduction of nearly $6,000. (McGrory, 3/17)

As many as a half-million Texans could become uninsured under the Republican plan to replace the Affordable Care Act, wiping out at least half the gains the state has made in reducing the number of uninsured residents in recent years, according to health care analysts. Texas still has the nation's highest percentage of people without health insurance, but that uninsured rate has dropped significantly, falling to about 19 percent from 26 percent over the past four years. About 1 million more Texans gained coverage under the health care overhaul known as Obamacare, which became law in 2010. (Deam, 3/18)

No congressional district in Wisconsin delivered a bigger victory margin for Donald Trump last fall (20 points) than the rural northern one represented by Republican Sean Duffy. But by one key measure, no district in Wisconsin would lose more health care aid under the GOP plan to replace Obamacare. (Gilbert, 3/18)

[Diane] Hughes was among the West Virginia residents gathered at the Robert C. Byrd Health Science Center here on Thursday for a town hall meeting on the Republican plan to overhaul the 2010 health care law. ... She credited the health care law with allowing her to participate in a behavioral health program that has helped her recover [from addiction to pain medication]. ... The Republican plan, which is scheduled for a House floor vote on Thursday, would eliminate a requirement relating to mental health and substance abuse services. Plans offered through the 2010 law’s Medicaid expansion were required to provide those services. (Bowman, 3/20)