Democratic and Republican officials outside of Washington are warning Congress that millions will lose healthcare coverage if the House GOP’s proposal to replace ObamaCare becomes law.

Almost all governors and state executive officers who object to the replacement hail from states that opted to accept federal funding to expand Medicaid under ObamaCare. The Republican replacement would roll back funding for the Medicaid expansion, forcing states to either shoulder the billions of dollars in costs themselves or drop new Medicaid recipients from the rolls.

In many states, budgets already stretched thin and threatened by declining growth in tax revenue have governors concerned they won’t be able to cover the costs without significant tax hikes.

“This proposal would kick 600,000 Washingtonians off Medicaid unless the state can come up with $1.3 billion, a burden that would be borne entirely by the state’s taxpayers,” Washington Gov. Jay Inslee (D) said.

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California Insurance Commissioner Dave Jones (D) said the GOP alternative could leave as many as 5 million of his state’s residents without health coverage, as premiums spike for residents covered under current rules.

“When it comes to making sure that the same number of Americans is insured, at the same level of affordability and with at least the same benefits, the GOP proposal fails on all counts,” Jones said in a statement.

“The GOP proposal will put coverage out of reach for some families who have coverage today and shift billions of dollars in costs to the states.”

Republicans, too, have objected to the bill proposed by their colleagues in Washington. About 700,000 Ohio residents gained coverage after Gov. John Kasich (R) opted to accept federal Medicaid expansion funding. Kasich said Wednesday he wanted to see an alternative before Congress rolls back that money.

“Phasing out Medicaid coverage without a viable alternative is counterproductive and unnecessarily puts at risk our ability to treat the drug addicted, mentally ill, and working poor who now have access to a stable source of care,” Kasich said in a statement.

Nevada Gov. Brian Sandoval and Illinois Gov. Bruce Rauner, Republicans who govern states that accepted Medicaid expansion money, also voiced concern that the new plan would drop hundreds of thousands of their residents from Medicaid.

Officials in some states pointed to residents who gained coverage through state or federal marketplaces.

Oregon Gov. Kate Brown’s (D) office said more than a million of her constituents are covered through state or federal exchanges, including almost 40 percent of residents in three rural counties represented in Congress by Rep. Greg Walden (R-Ore.), who chairs the House Energy and Commerce Committee.

Pennsylvania Gov. Tom Wolf (D) said up to a million Keystone State residents could lose coverage under the bill.

Rhode Island Gov. Gina Raimondo (D) said the Republican replacement would slash funding for the ongoing fight against opioid addiction, a public health crisis that has claimed thousands of lives across the country in recent years.

The Affordable Care Act provides “urgent funding for our battle against the opioid crisis that takes lives and impacts families from every walk of life,” Raimondo said Tuesday. “We cannot go backward on these crucial investments in the people of Rhode Island.”

Virginia Gov. Terry McAuliffe (D) said the replacement measure would impact more than 320,000 of his constituents who receive coverage with the help of subsidies through the federal exchange. Virginia did not accept Medicaid expansion money, and the new GOP scheme would put the commonwealth “at a permanent economic and health disadvantage to states that did,” McAuliffe said.