Leaders of the Iowa Hospital Association are raising concerns about Republican proposals they say would end federal funding of health care coverage for more than 100,000 low-income Iowans.

“People fear the health care system in this country,” Ted Townsend, president and CEO of UnityPoint-St. Luke’s Hospital in Cedar Rapids said. “…Our goal is to try to protect the fact that we’ve made some progress.”

The expansion of government-paid Medicaid coverage that’s been part of “ObamaCare” would be phased out under the alternative that cleared the Republican-led U.S. House earlier this year. Republicans in the Senate are crafting their own plan in private. Iowa hospital executives warn the end of Medicaid expansion will hit low-income Iowans who’ve benefited from getting regular check-ups and care for chronic conditions like diabetes. Mike Myers, the CEO of Veterans Memorial Hospital in Waukon, is chairman of the Iowa Hospital Association’s board of directors.

“On a weekly basis, we would have people come in so ill that they required transport to the University of Iowa or another tertiary center for very extensive care,” Myers said. “Since that time, it’s rare that we have somebody come in with their diabetes out of control, heart failure, an infection that they let go and the fear is to go back to that is a big step backwards in the health status of individuals.”

Steve Baumert, president and CEO of Methodist Jennie Edmondson Hospital in Council Bluffs, said there are “countless stories” in his city of people who’ve been helped by the expansion of Medicaid, including one homeless man who was a frequent emergency room patient who’s now seeing a doctor regularly, has a job and is living in a home.

“Those types of efforts clearly would be threatened with the reduction in Medicaid funding,” Baumert said.

Charity care at his hospital in Council Bluffs has been cut in half since 2013 when Medicaid was expanded. Iowa Hospital Association CEO Kirk Norris said hospitals all across the state are seeing similar trends.

“Charity care levels since the expansion of Medicaid in Iowa have severely dropped,” Norris said.

The Iowa Hospital Association represents 118 hospitals.