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Republican Gov. Bruce Rauner on Tuesday said he's worried Illinois "won't do very well" if the proposed U.S. House Republican Obamacare replacement plan becomes law.

The governor's comments were his first since congressional Republicans unveiled their changes Monday. The plan would cut federal funding to Medicaid, the health insurance program for the poor and disabled paid for with state and federal dollars.

In Illinois, about 3 million, or 1 of every 4, residents are on Medicaid, including about 650,000 people insured under Medicaid expansion. The state is getting an estimated $14.1 billion in federal money this year to support traditional Medicaid and Medicaid expansion.

The House GOP plan would switch state reimbursement from a federal match to a limited amount of money, blowing a big hole in a state budget that's already severely out of whack amid a record impasse in Springfield.

Rauner referred to the proposal as "a pretty significant shift" but said he hadn't had a chance to "analyze every piece" of the legislation.

"My first blush read is Illinois won't do very well under the changes that they're recommending, which is a big concern to me," Rauner said. "I want to make sure that people in Illinois are not left in the lurch or that, you know, there's a lot of pressure to reduce insurance coverage for people in Illinois. I'm very concerned about that."

Rauner said he had spoken with fellow governors and with members of the Trump administration about his concerns regarding Medicaid, but he refused to tell reporters what those concerns were. He said he planned to talk with members of Congress and with governors "to craft a joint response or some recommendations to what's been proposed."

"It's a little early for me to publicly state what I've recommended," Rauner said.

Also Tuesday, Mayor Rahm Emanuel criticized the Republican plan, saying it would cost millions of low-income Americans their health insurance while driving up health care costs across the country.

The mayor said he discussed the bill unveiled this week by the GOP at the behest of President Donald Trump with his brother, renowned health care ethicist Ezekiel Emanuel.

"I have not had a chance to go through the whole bill, but I have read parts of it, and I at least called the family expert, my older brother," Emanuel said. "And my fears, which is true, and that is more people are going to lose health care, you're going to get away from the cost containment that has happened, and it's directly going to impact poor and working poor, or working lower middle-class access to quality care because of the way it's designed."

The mayor contrasted the Republican plan with the work he said went into crafting the Affordable Care Act known as Obamacare when he was chief of staff in the Obama White House.

"At no point in those two years did anybody ever say, 'You know what we should do? Let's cut taxes for health insurance executives.' That never came up," he said. "The entire discussion was, how do you keep health care costs under control, and how do you expand health care. Not how do you provide a tax cut to CEOs of health insurance companies and then diminish people's access to quality health care."

The plan Republicans in the House released Monday evening would phase out funding to states that use Medicaid to provide health insurance to low-income residents. It also would roll back taxes on high incomes, including a clause in Obamacare to tax insurance executives who make more than $500,000.

Obamacare has been in Republicans' crosshairs for years, and Trump has made its repeal a key part of his platform. It's far from certain this proposal unveiled by House Republicans will make it to Trump's desk, however. A handful of Republican senators have already expressed misgivings about it.

Chicago Tribune's Lisa Schencker contributed.

jebyrne@chicagotribune.com

kgeiger@chicagotribune.com

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Rauner: Illinois 'won't do very well' under Republican health insurance plan - Chicago Tribune