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BOSTON — Massachusetts could lose billions of dollars under the latest effort to repeal and replace Obamacare, which specifically singles out blue states that have expanded Medicaid coverage under the federal law.

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At the end of July, the nation held its collective breath as Senate Majority Leader Mitch McConnell (R-Ky.) looked poised to achieve his most formidable parliamentary accomplishment: the repeal and replacement of the Affordable Care Act.

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WASHINGTON — As Senate Republicans make a final stab this year at undoing former President Barack Obama's health care law, health care advocates are urging their legislators to vote against the measure.“We believe in protecting our neighbor,” said Perry Bryant, president of West Virginians for Affordable Health Care.Alarmed by an independent estimate the bill would cost the state $1 billion in funding used to help hundreds of thousands afford medical coverage, Bryant urged Sen. Shelley Moore Capito “not to vote as a partisan politician in D.C.”Republican leaders are hoping a different approach and the urgency of following through on campaign promises will this time muster enough votes to get rid of the controversial law.However, they face some of the same obstacles as in July, when their effort fell a vote short.GOP senators from states like West Virginia and Ohio — where Medicaid coverage was expanded to more people — face the prospect of supporting the loss of millions of dollars that help people afford medical coverage. Republican governors from those states, like Massachusetts' Charlie Baker and Ohio's John Kasich, are opposing the bill.Health care advocacy groups representing doctors and hospitals, along with the AARP, say allowing states to undo the law's regulations would again allow insurers to charge older people and those with medical conditions higher premiums.

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WASHINGTON - President Donald Trump's proposal to cut federal spending by more than $3.6 trillion over the next decade - including deep reductions for programs that help the poor - faced harsh criticism in Congress on Tuesday, where even many Republicans said the White House had gone too far.