Louisiana’s Health Secretary Rebekah Gee wants Sen. Bill Cassidy (R-LA) to know his health care proposal — the last Republican proposal to repeal and replace Obamacare — “uniquely and disproportionately hurts his home state of Louisiana.”

Gee, who was appointed by Democrat Louisiana Gov. John Bel Edwards, wrote Cassidy a letter this week, which she published on Twitter Tuesday, to warn the Louisiana senator of the outsized risks of pursuing the Cassidy-Graham-Heller-Johnson health care plan.

“In its current form, the harm to Louisiana from this legislation outweighs any benefit,” Gee wrote, first and foremost citing her concerns about the bill’s impact on Medicaid. “Because this bill eliminates Medicaid expansion in 2020, all of our efforts would end, and thousands of Louisiana citizens would lose coverage and access to critical health care services. This would be a detrimental step backwards for Louisiana.”

The proposal, which originated from Cassidy and Sen. Lindsey Graham (R-SC) would block-grant Obamacare’s existing funding, cap federal health care spending, and send the money to states to form their own health care programs. In effect, the Center for Budget and Public Policy concluded that this plan would largely redirect money from states that expanded Medicaid to states that didn’t. According to CBPP, Louisiana would see upward of a $2.3 billion cut in federal health care funding over the next decade.

My letter to @BillCassidy explaining how his bill uniquely and disproportionally hurts his home state of Louisiana. pic.twitter.com/5re6ETMMiw — Rebekah Gee (@rebekahgeemd) September 19, 2017

Cassidy is instead pushing rosier numbers, making it appear as though Louisiana wouldn’t see a cut at all. He’s saying block grants would increase by 4 percent between 2020 and 2026; his estimates come from major calculation flaws, CBPP analysts Aviva Aron-Dine, Edwin Park, and Matt Broaddus discovered.

“These estimates do not compare states’ funding under the proposal to what states would receive under current law, the relevant comparison. Instead, they show how each state’s funding under the proposed block grant would change over time,” they write.

Furthermore Cassidy’s estimates 1) do not take into account that the proposal puts a “per capita cap” on Medicaid, which would result in an estimated $39 billion cut in 2026, 2) do not account for changes in health care costs between 2016 and 2026 or a likely growth in the number of people needing assistance over the decade, and 3) don’t measure the effects of this proposal after 2026, when the bill would end block grant funding, increasing health care spending cuts from $80 billion in 2026 to $300 billion in 2027.

The Louisiana senator fired back at his state’s health secretary, saying Gee chose to “echo a left wing think tank which is working to preserve Obamacare.”

Cassidy firing back at his state's health sec. Says she's echoing a "left wing think tank which is working to preserve Obamacare." pic.twitter.com/9kKiucQKMZ — Alex Ruoff (@Alexruoff) September 19, 2017

Cassidy-Graham-Heller-Johnson has not yet received an official score from the Congressional Budget Office, the nonpartisan body that analyzes the cost and coverage of bills — although Cassidy has long expressed that he disagrees with the CBO’s analyses on health care.

Gee warned Cassidy that his health care proposal would fall into some of the same traps as past iterations of the Obamacare repeal effort, including per-capita caps and allowing for state-based waivers for essential health benefit coverage, which could adversely impact people with preexisting conditions.

“The legislation you have introduced this past week gravely threatens health care access and coverage for our state and its people,” Gee wrote. “A generational bill as transformative as this one, that would overhaul aspects of nearly one-fifth of this country’s economy, should be done through regular order with public hearings.”