Sen. Lindsay Graham

Republican lawmakers’ last shot at repealing and replacing the Affordable Care Act ahead of a Sept. 30 deadline is not earning any fans in the long-term care sector, the nation’s largest provider groups confirmed on Tuesday.

The bill, introduced by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), would repeal individual and employer insurance mandates, as well as move insurance subsidies and Medicaid expansion funds into a block grant system. Republicans are viewing the bill as their last viable chance to overhaul healthcare before the deadline, with House Speaker Paul Ryan (R-WI) saying the legislation is “our best, last chance to get repeal and replace done.”

But long-term care providers are among the healthcare groups again pushing back hard against the plan. They are united in their distaste for its Medicaid proposals, fearing the block grant structure could cut funding from cash-strapped facilities.

“The Medicaid cuts proposed in the Graham-Cassidy Bill — including a reduction in provider assessments that alone will result in billions of dollars less to long term care each year — are catastrophic,” Mark Parkinson, president and CEO of the American Health Care Association/National Center for Assisted Living said in a statement. “Reducing provider taxes will devastate state budgets, amounting to an average additional cut of nearly $200,000 per center each year.”

Those Medicaid provisions, combined with providers’ already “razor thin” margins, could force many facilities to close, Parkinson noted.

Niles Godes, senior vice president of congressional affairs for LeadingAge, said his group fears shifting the Medicaid program to block grants also would “threaten the security” of beneficiaries who require care “precisely when the need is greatest.”

“Per capita caps and block grants would so radically restructure Medicaid that the program would be unrecognizable from its current form,” Godes said. “We urge Senators to oppose the Graham-Cassidy bill. It is bad for older adults and bad for America.”

A hearing in the Senate Finance Committee on the bill is currently scheduled for Monday. Should the bill pass the Senate, Ryan is aiming to deliver it straight to the House floor for a vote.

The Congressional Budget Office warned this week that efforts to fast track the bill would allow it time only for a preliminary assessment, not the full scoring process that would reveal the full extent of potential Medicaid cuts under the legislation. Recent ACA-replacement proposals have been projected to cause tens of millions of people to lose healthcare coverage, a political wedge that could come into play again.