The proposed US House Republican health plan threatens Washington consumers, health and insurance officials say.

House Republicans on Monday released their long-awaited plan for replacing former President Barack Obama's Affordable Health Care Act (ACA).

It appears thousands of people in Southwest Washington could lose coverage or have coverage diminished, Dian Cooper, executive director of the Cowlitz Family Health Center, said Tuesday.

The center operates clinics in Cathlamet, Longview, Ocean Park, Kelso, Castle Rock and Woodland.

"That (the healthcare bill) would not be good if it were to pass the way it is currently written," she said. "So in Cowlitz, Wahkiakum and Pacific counties, there are about 15,000 people who have benefitted from the Affordable Care Act by

being able to get Medicaid coverage.

"That would go away by 2020, and they would be uninsured.

"There are another close to 3,000 people who have benefitted from the ACA by being able to purchase insurance on the exchange. Most of those are getting some help to help them pay the premiums. They will have to change their insurance if this legislation is passed or become uninsured.

"Regardless of what happens, we will serve as many people as we can. So, we're not planning on closing clinic doors."

In Olympia, state Insurance Commissioner Bob Kriedler said the congressional Republicans’ plan to replace the Affordable Care Act is a step backward for the millions of people who have gained coverage.

"It’s being rushed to a vote with little or no public review or fiscal analysis by the nonpartisan Congressional Budget Office," Kriedler said in a Tuesday statement. "This is an unprecedented way of doing the public’s business.

"As a former member of Congress and our state’s insurance regulator, I am troubled by the lack of transparency.

"My office will have a more detailed analysis of the Republican plan in the coming days. Our initial review highlights ways the proposal threatens consumers:

--Eliminates the individual mandate. Dropping the individual mandate for coverage could prompt insurers to flee the market if not enough healthy people buy insurance. Washington state tried a similar measure in the 1990s and saw the individual health insurance market collapse.

--Surcharge no substitute for mandate. A 30 percent surcharge for a gap in coverage of more than two months – billed as “continuous coverage” – is a weak attempt to replace the individual mandate.

--Inequitable tax credits. Tax credits replace income-based subsidies, meaning the poorest residents are at risk of eventually losing or foregoing coverage.

--Tax shelter for higher incomes. Expanded use of health savings accounts – or tax shelters – fail to help low-income people who have no money to put into this type of account.

--Older people pay more. Older people will pay significantly more for coverage in a couple of ways. The Republicans’ plan allows insurers to charge older consumers up to five times more than younger consumers. It replaces income-based subsidies with age-based tax credits, which possibly may not offset increased premiums.

--No coverage for abortion. The proposal forbids tax credits for any health care plan that covers abortions. This is a direct attack on women’s rights and would lead to higher costs overall.

"Despite keeping some of the most popular protections of the Affordable Care Act," Kriedler said, "the Republican plan is almost certain to increase the rate of uninsured in Washington and throughout the nation. Many people literally will be faced with life-and-death choices because of the inequities that make up the Republican proposal."

"Guaranteeing ‘access' does not guarantee that people have affordable coverage. It’s just another way of saying that if you don’t have enough money to pay for health coverage, you’re out of luck.