ST. PAUL, Minn. (WCCO) — Minnesota health care leaders are alarmed about deep cuts to Medicaid coming out of Washington.

Minnesota is one of 31 states to expand Medicaid under Obamacare, to cover low-income patients. But under President Trump’s new health care bill, a lot of that money could go away.

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Democratic Governor Mark Dayton expanded Medicaid his first week in office, and it was controversial even then.

Now more than a million low-income Minnesotans are enrolled in Medicaid — a record — which helps them get regular medical care.

More than 500,000 Medicaid recipients are children, and hospitals worry the state won’t be able to replace the lost money.

“As the law is currently written, it appears that the effort to restructure Medicaid will significantly reduce services for our most vulnerable population,” Dennis Jolley of Gillette Children’s Specialty Healthcare said.

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Minnesota now spends about $5 billion a year on Medicaid, most of it paid by the federal government. The Trump plan cuts $1.5 billion in 2018, and $1.6 billion in 2019. Health care advocates say that’s a direct hit.

“Services will be cut for those most in need — vulnerable seniors, people who are living with disabilities,” Will Phillips of AARP Minnesota said. “People whose long term care needs are most expensive.”

The cuts could blow a hole in the state budget, but one influential health care lawmaker says Medicaid spending was unsustainable. Republican Representative Matt Dean says the overhaul lets Minnesota restructure its once-world famous health care system.

“I think we can do things the Minnesota way, and do it cheaper and do it better,” he said. “We had the most to lose by jumping into Obamacare, which was a swimming pool without any water. We need to do it our way. We can do it cheaper than they are telling us.”

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Republicans in Washington say their health care bill to replace Obamacare is a “work in progress” but they expect to vote on it in the next several weeks.