WASHINGTON (AP) — An independent study finds most states would take a stiff budgetary hit if the latest Senate GOP health care bill becomes law.

The consulting firm Avalere Health says the Graham-Cassidy bill would lead to an overall $215 billion cut to states in federal funding for health insurance, through 2026.

Over 20 years the cut would total more than $4 trillion, assuming the legislation passes and remains on the books, said the analysis released Wednesday. The bill limits federal Medicaid funding.

The study found winners and losers. Thirty-four states would see cuts by 2026, while 16 would see increases. Among the losers are several states that were key for President Donald Trump, including Florida, Pennsylvania, Michigan, and Ohio.

GOP leaders and the White House are pushing for a vote next week.

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