WASHINGTON -- House Republican cuts to Medicaid in the American Health Care Act would hit New Jersey harder than any other state.

The bill would leave 500,000 more Garden State residents without health insurance than under current law, and New Jersey no longer would get extra federal funding for expanding Medicaid.

While New Jersey officials likely won't seek waivers to allow insurers to sell bare-boned insurance policies and jack up rates for those with pre-existing conditions, the House Republicans' health bill would hurt the state in many other ways.

"This waiver just made things worse but it was bad enough before the waiver," said Rep. Frank Pallone Jr. (D-6th Dist.), who led the fight against the Republican bill as the top Democrat on the House Energy and Commerce Committee.

Rep. Tom MacArthur (R-3rd Dist.), whose proposal on the state waivers led to approval of the Republican measure, said the Medicaid cuts are designed to force states to try hold down health care costs.

"What the Medicaid reforms really do is put pressure on the states to get costs under control," MacArthur said. "That's where the pressure is. It's not going to be on patients. I don't ultimately believe it will be on hospitals or doctors either. It's going to be on states."

President Donald Trump, meanwhile, criticized coverage of the Republican legislation, which the Congressional Budget Office said would leave 24 million more Americans without health insurance than under current law.

Wow,the Fake News media did everything in its power to make the Republican Healthcare victory look as bad as possible.Far better than Ocare! — Donald J. Trump (@realDonaldTrump) May 5, 2017

A study by the Urban Institute found that federal Medicaid funding to New Jersey on a per person basis would drop by 20.6 percent, more than any other state.

That could threaten the health cate of 1.8 million New Jersey seniors, people with disabilities and children, according to New Jersey Policy Perspective, a progressive research group.

"The point of the bill is to reduce federal funds," said Ray Castro, NJPP's director of health policy. "It's going to be less than what we need."

New Jersey would be hit hard because the GOP bill caps Medicaid spending for the poor, elderly and disabled, ending an entitlement in which expenditures funded by the federal and state governments fluctuated depending on how many residents qualified for the program.

The cap would cost New Jersey $30 billion in federal funds over 10 years, causing the state to lose tens of thousands of jobs, according to NJPP.

In addition, states like New Jersey that expanded Medicaid no longer would get extra federal funding for new recipients after 2019.

The state also would lose the extra funding for an individual who temporarily got off Medicaid and then came back onto the program. That happens often as someone lands a temporary job for a month or two and then needs assistance again, Castro said.

New Jersey is projected to have 553,000 adults with coverage due to the Medicaid expansion in 2019, according to the Urban Institute.

The state would have to increase its Medicaid spending by 35.6 percent to make up the GOP cuts, the study said.

But Trump and House Republicans also want to eliminate the federal deduction for state and local taxes, which would make it harder for New Jersey to raise its levies to ease the pain on its lowest-income residents.

"The state's going to lose all of this money," Pallone said. "How are they going to cover this medical population that's left?"

In all, the Republican health care bill would cut Medicaid by almost $840 billion over 10 years, with most of that money going to cut taxes for corporations and wealthy Americans.

Meanwhile, the lower subsidies would raise the cost of health insurance for many buying coverage on the exchanges set up under the Affordable Care Act. A 60-year-old living in Monmouth County and making $20,000 a year would see premiums rise to $9,660 from $960, according to the Kaiser Family Foundation.

"You cut out the funding," Pallone said. "Republicans said repeal and replace. There can't be an effective replacement because there's no money."

Jonathan D. Salant may be reached at jsalant@njadvancemedia.com. Follow him on Twitter @JDSalant or on Facebook. Find NJ.com Politics on Facebook.