Illinois could face nearly $40 billion in lost federal Medicaid support over 10 years under a health care overhaul proposed last week by congressional Republicans and supported by President Donald Trump, a health industry spokesman told state lawmakers Thursday.

Three Illinois House committees heard testimony from experts on how major changes to Medicaid outlined in the American Health Care Act could affect the state's recipients. The GOP plan to replace former President Barack Obama's health care law would phase out an expansion of Medicaid and cap federal spending for the entire program going forward.

Illinois Health and Hospital Association spokesman David Gross testified that Illinois would lose at least $38 billion in federal Medicaid funding over the act's 10-year lifespan. The association arrived at this figure by taking Illinois' share of the nation's Medicaid beneficiaries and multiplying it by the $880 billion in reductions estimated by the nonpartisan Congressional Budget Office under the Republican plan. Gross said the cuts would jeopardize patient care.

Democratic Rep. Greg Harris of Chicago, who chairs the appropriations committee for human services, said one in four Illinois citizens receives Medicaid benefits and could be affected.

Illinois currently devotes $10 billion in state funds each year to Medicaid, or about one-quarter of the general fund. The federal government matches that amount.

Harris said lawmakers would need to find ways to fill the $4 billion-a-year hole.

"That's money the state has to come up with, out of tax dollars," Harris said. Otherwise, he said, Illinois would have to cover fewer people, offer fewer services or cut rates to care providers.

The Republican plan would phase out the Affordable Care Act's nationwide expansion of Medicaid to 11 million additional low earners. In Illinois, 650,000 citizens have gained coverage under the expansion, the federal match for which would begin to diminish in 2020 under the Republicans' proposal. Gross said two-thirds of those enrolled under the expansion could face restricted federal coverage by 2021 depending on fluctuations in income or other circumstances.

The overhaul would also cap federal support given to states for Medicaid recipients instead of matching whatever states decide to spend.

Republican Rep. Tom Demmer of Dixon said that although the Affordable Care Act succeeded in extending coverage, it has also led to increased premiums and restricted choices for individuals buying insurance on the state market.

Roberta Racove, a spokeswoman for the Chicago-based Sinai Health System, told lawmakers that Medicaid expansion made it easier for Sinai's network of charitable facilities to care for patients regardless of insurance status. Before the expansion, she said, 15 percent of Sinai patients were uninsured. That figure fell by more than half under the Affordable Care Act.

"The expansion has taken us to a new level," she said. "It's taken us beyond survival."