The latest Republican move to repeal the Affordable Care Act and instead pay states to shape their own systems would hit Hawaii particularly hard, according to health care analysts.

The legislation proposed by Senate Republicans Lindsey Graham of South Carolina and Bill Cassidy of Louisiana would replace Obamacare coverage with grants to states.

In the process, it would take federal funds from states that chose to adopt the Medicaid expansion offered by the ACA — including Hawaii and 30 other states — and redistribute them to non-Medicaid expansion states.

Anthony Quintano/Civil Beat

A New York Times analysis showed Hawaii would be the 11th-hardest hit state in terms of funding cuts per person.

By 2027, according to an analysis done by the Center for American Progress, 95,000 Hawaii residents would either lose or have significantly reduced health insurance coverage.

And health care consulting firm Avalere estimates that from 2020 to 2036, Hawaii would lose about $30 billion in federal funding — a 43 percent decrease.

Not surprisingly, all four members of Hawaii’s congressional delegation have spoken out against the bill, which could come to a vote in the Senate as soon as Tuesday.

“Each previous bill did some bad things. This one combines the worst ideas into a package,” said Sen. Brian Schatz in a tweet Thursday.

Rep. Tulsi Gabbard voiced her concern that the Graham-Cassidy bill would be particularly bad for the Aloha State.

Graham-Cassidy would devastate Hawaiʻi. We will not accept health care cuts for millions to fund tax cuts for the wealthy. #ProtectOurCare — Tulsi Gabbard (@TulsiGabbard) September 19, 2017

And Rep. Colleen Hanabusa tweeted her concerns about losing coverage of pre-existing conditions.

Under #GrahamCassidy, states can allow people w/ pre-existing conditions to pay more. It’s the worst #Trumpcare bill yet. #ProtectOurCare — Colleen Hanabusa (@RepHanabusa) September 20, 2017

The islands’ congressional delegates also were unimpressed by reports that Republicans might offer to exempt Hawaii and Alaska, allowing them in essence to keep the benefits of the Affordable Care Act and the Medicaid expansion that goes along with it, in an attempt to convince Alaska Sen. Lisa Murkowski to vote for the bill.

Murkowski, a Republican, cast a pivotal vote against a previous attempt to repeal the ACA.

The possible exemptions were reported by two online news organizations, the Independent Journal Review and The Week.

Hawaii Sen. Mazie Hirono seemed to be responding to those reports in a Thursday tweet.

Hawaii will not succumb to ham-fisted #GrahamCassidy divide and conquer tactics. We will not throw the rest of the country under the bus. — Senator Mazie Hirono (@maziehirono) September 21, 2017

Schatz expressed similar sentiments in a tweet Thursday morning, writing, “Every state should be able to keep their premium tax credits and Medicaid program. That’s not a special deal, that’s the current law.”