As Congress clashes over repealing the Affordable Care Act and replacing it with President Donald Trump’s American Health Care Act, Lt. Gov. Kathy Hochul is raising the alarm about the impact the move could have in New York. In a press release earlier this week, Gov. Andrew Cuomo said the latest Republican plan would leave 2.7 million New Yorkers without health care and cut $4.7 billion from the state’s Medicaid budget. The stakes were raised when New York Reps. John Faso and Chris Collins – who knocked Hochul out of Congress in 2012 – tried to make the legislation more appealing by introducing an amendment to shift county Medicaid costs to the state. On Thursday evening after a planned vote had been posponed, Hochul spoke with City & State’s Ashley Hupfl about her concerns with the GOP proposals and to urge the New York delegation to vote against the AHCA. The following is an edited transcript.

C&S: What are your concerns with repealing and replacing of the Affordable Care Act?

KH: In the last 48 hours I’ve been to about 10 or 12 cities and talking to people all over the state who are very optimistic and hopeful that, particularly the Republican members of Congress, the nine of them that represent the state of New York will do the right thing and vote against the repeal overall – but most certainly never, ever again consider the Collins-Faso amendment, which would inflict irreparable damage to the state of New York. It’s something we find inconceivable that members of our own delegation have convictions that would keep $2.3 billion from the state of New York.

I wanted to share some of those thoughts because I’m really hearing it among the people as I go into diners and restaurants in even some of the most conservative parts of the state. For example, the congressional district I once represented, there are people now that are becoming very fearful that these benefits they’ve been receiving under the Affordable Care Act would disappear. What I find really depressing is that a lot of people really were not aware that they were beneficiaries of Obamacare and the Affordable Care Act. They were confused by the name and now they’re becoming more educated and fearful. I found that really tragic that in a state like New York that people have to be afraid of losing basic health care services that everyone should be entitled to. We have 7 million New Yorkers who are exposed and 2.7 million that are very much in danger of losing their health care overall. We need to sign the alarm and let them know what people are saying.

C&S: What’s your take on the vote being delayed in Congress?

KH: I think it’s an indication that the people’s voices are starting to penetrate through the halls of Capitol Hill. I think the voices of people like those in Wyoming County and Orange County are starting to be heard, because I think the members are getting nervous about what they thought would be an early vote. They thought they were reacting to the political winds, but now the electorate is very smart, they know this isn’t in their best interests and starting to make their voices heard. I think there’s going to be a lot of reconsideration going on, which is exactly what the governor and I had hoped for when we started this campaign to really educate the public and make sure they know New York is very exposed here.

Again, I’m very moved by the stories I’m hearing from people. For example, this past Sunday I was in Wyoming County, which I think if you checked is the most, if not one of the most top Republican counties in New York. It’s part of my old congressional district. There’s good people, hard-working people and we sat at (a pancake house) to celebrate Maple Weekend and I’m eating my pancakes and literally people are coming up and telling me stories of how they’re so afraid they’re going to lose their health care. A 59-year-old woman said she lost her job and won’t receive Medicare until she’s 65 and she’s been relying on (the ACA). She thinks the payments are reasonable, she supports it, it’s been working and now she’s afraid it’s going to disappear. So, these voices need to be heard and these voices are the ones that are touching the governor and I and making feel even more emboldened and realizing how important it is to stand up for these people.

Standing up for New Yorkers literally against their own Congress members should not be the case. They should be fighting for the state of New York – not against it and that is why the proponents of the Faso-Collins amendment are just so out of touch and so wrong out of their approach in saying that they can relieve these counties by basically pushing the cost to the state. Who do you think the state is? Those are fellow New Yorkers who are going to have to pick up the tab or else the alternative is to have upwards of $2.3 billion in cuts to the most neediest. The largest beneficiaries of Medicaid dollars in the state of New York are the most vulnerable – the elderly, these are people in nursing homes. What is their alternative if they’re not in a nursing home when you’re elderly parents or grandparents need assisted living or nursing home care? Where are they going to go? To your spare bedroom? There’s a system that works and if they pull the plug on it, we’ll be on life support.

C&S: What impact do you think the Collins-Faso amendment had on the decision for some Republicans to choose not to support the bill?

KH: I think that it was held out to an enticement to some of them. I think some of it was actually a bribe, for (U.S. Rep.) Chris Collins in particular carrying the water for President Trump as he’s been doing for the last year and saying, “Hey, I can bring these on-the-fence, thoughtful Republicans that otherwise wouldn’t go for it. I can bribe them with this thought that we can help the upstate counties” – but, without thinking through the inevitable consequences. That has to be paid by someone. Figuring out the logical consequences is that the bill has to be paid by someone. The way it’s structured, if the federal government is going to step in and cut their funding – it is the state of New York (that’s responsible). Fellow New Yorkers are either going to have an enormous tax increase or they’re going to have cuts in services. So, again, why members of our own delegation would stab their own state – no other state is doing this. There are 16 state in America where they share the cost of Medicaid with the counties, but this punitive measure would only effect New York state. I’m not even sure how that’s legal. How can you single out one state for this treatment? And it’s being perpetrated by members of our own delegation and that is unconscionable.

CS: What other ACA provisions could be detrimental to New Yorkers if left out?

KH: Well, we’re talking about a $400 million cut to nursing homes, so which nursing homes are going to close in which district? A $360 million cut to home care payments and to keep the cost of health care down – we’re trying to encourage people to get home care as opposed to having institutional care. Those payments are out the window and $355 million cut to hospitals. We’ve analyized each of the hospitals and how much they would lose and you look at Chris Collins’ area, Western New York, they stand to lose $65 million. I mean, that’s going to gut institutions like Erie County Medical Center and places that people go to when they need help. Also, not just health care services, these places are huge employers, particularly in the rural areas where sometimes the hospitals are the largest employers. So, there will be job losses, service cuts and for what reason?

I know through no fault of anyone in the millennial generation, many of them are strangled with student loan debt, they can’t go out and get their own apartment, they certainly can’t buy a house, so they’re spending more time with mom and dad trying to get their first job. They didn’t do anything and now they could be thrown off their parents’ health insurance? Before Obamacare, you could have a 4-year-old diagnosed with leukemia and insurance companies could say, “No that’s a pre-existing condition, we don’t have to cover that treatment.” I’ll never forget when a mother ran up to me at a county fair and threw her arms around my neck with her child next to her and said, “Thank you for your support for the Affordable Care Act, because my baby could not get medical attention, because the insurance companies had said no before.” Those are real-life New York stories that need to be heard and told.