The proposed changes to Medicaid in a draft of the Republican healthcare bill would cut federal funding for the program in Alaska by 28 percent and cause tens of thousands of people to lose coverage, according to a report released Thursday by Alaska's health department.

Under the draft of the bill, the Better Care Reconciliation Act, Medicaid expansion would be rolled back in states that expanded it to low-income residents under Obamacare. Over the long term, it would allow states to choose between receiving a fixed sum of federal dollars from Medicaid as a per-capita cap or a block grant and reconfigures the program's growth rate to match overall inflation rather than current, faster-increasing medical inflation.

Alaska would lose $3.1 billion in federal Medicaid funding between 2020 and 2026, according to the report. To stay under the cap, the state would need to cut Medicaid spending by $632 million in both federal and state dollars.

By cutting federal funding from expansion, 34,000 low-income people would lose coverage, the report estimates. The report didn't speculate how many could lose coverage under traditional Medicaid, which covers children, people in nursing homes and people with disabilities, saying only that they were "at increased risk for cuts."

One of Alaska's senators, Republican centrist Lisa Murkowski, has urged Senate leaders not to make changes to Medicaid, according to reports. Republicans are facing a narrow margin to pass the bill — or even to open it for debate — and cannot afford to lose support from more than two senators.