Legislation to revise the Affordable Care Act drew swift condemnation in Connecticut, with critics saying it will raise health care costs and remove protections for older and sicker people.

Changes to the legislation that were made to woo conservative Republicans let states elect to decide what services health insurance plans must cover and whether insurers have to sell plans to patients with preexisting conditions at the same rates as healthy patients.

Lt. Gov. Nancy Wyman, chairwoman of the state's Health Care Cabinet, chastised the Republican bill and said Connecticut would not seek a waiver for either the "essential health benefits" or preexisting conditions mandates.

"I'm hoping that the Senate is a much more reasonable group of people and will go in there and change this bill because it's going to be hurting individuals and hurting our state tremendously," she said.

Wyman said she was convening a bipartisan group to study the federal changes and better understand how they would impact the state. As many as 800,000 people on Medicaid or who buy insurance through the state's exchange, Access Health CT, would be affected by the law, she said.

Gov. Dannel P. Malloy said the vote was "appalling." His budget office estimated earlier this year that a previous version of the American Health Care Act could cost Connecticut up to $1 billion a year.

"Our collective concern should be about stabilizing the marketplace and increasing access for all individuals to quality health care," Malloy said in a written statement. "The only thing that this proposal accomplishes is ensuring that when it comes to health care, Americans pay more for less."

The CEO of the Connecticut Hospital Association, Jennifer Jackson, said her organization was "deeply concerned" about the bill approved by the House Thursday.

"The bill would remove protections for older and sicker patients, including those with preexisting conditions, and make deep cuts to Medicaid, which is a lifeline for the poor. This is particularly problematic in Connecticut because this state's Medicaid reimbursement is already one of the lowest in the nation, with providers being paid less than half of what it costs to provide care,'' Jackson said. "We call on the U.S. Senate to reject this bill and protect the most vulnerable members of our society."

The Republican plan replaces subsidies offered under the Affordable Care Act with tax credits depending mainly on age. It also includes more than $880 billion in cuts to Medicaid over the next decade and repeals taxes that were part of Obamacare, saving high-income earners an estimated $300 billion over the same period of time.

Ken Ferrucci, senior vice president of government affairs at the Connecticut State Medical Society, said Connecticut has put in protections for patients that may insulate them from some of the provisions in the Republican health care law, "but financially I think it could have a big impact."

Democratic leaders in the General Assembly said the state has no money to make up for the cuts in Medicaid.

"If this bill moves forward as is, we expect it will create a significant additional problem in our state budget or force us to abandon meaningful reforms that are working," Senate President Pro Tempore Martin Looney and Senate Majority Leader Bob Duff said in a joint statement.

Congressional Democrats, including Connecticut's five House members, all voted against the American Health Care Act, saying it would strip coverage from tens of millions of Americans while cutting taxes for the wealthy. The bill passed by a slim margin and awaits action in the Senate.

"If this bill were to become law, we would see an estimated 24 million Americans, possibly many more, thrown off their insurance," said Rep. Jim Himes, D-4th District. "Americans will live sicker. Americans will die sooner."

Rep. Joe Courtney, D-2nd District, said the Republican legislation "does nothing" for those who are frustrated with weaknesses in the Affordable Care Act and pressed for a bipartisan health care solution.

Rep. Rosa DeLauro, D-3rd District, said Trump was going back on a promise to cover patients with preexisting conditions, a provision of Obamacare. The bill sets aside billions of dollars for a fund to help states and insurers deal with high-cost patients, but observers said that would not be nearly enough to provide coverage for millions of high-risk enrollees.

"President Trump's claim that people with preexisting conditions will be covered ... that is false and it is a betrayal and it will have threatening consequences for millions of Americans," DeLauro said on the House floor Thursday morning.

Rep. Elizabeth Esty, D-5th District, said in a tweet that she had gotten 45 calls and emails in favor of the Republican health care bill and 3,148 against.

"I represent a purple district," Esty said, referencing the political makeup of the 41 central and northwestern Connecticut towns she serves.

The bill, Rep. John Larson, D-1st District, said, "Was about tax cuts and not about the health care of the American people."

Outside the Capitol, Sen. Chris Murphy, D-Conn., joined progressive activists from MoveOn.org, pledging to hold House Republicans who voted for the bill accountable.

"There aren't that many life or death votes in this place. This is one of them," Murphy said. "Inside that House chamber is a red button and a green button. The individuals who press that green button are making a decision to kill thousands and thousands and thousands of Americans."

The bill will face tougher opposition in the Senate, where Republicans hold just a two-vote majority, and political observers expect it will need to be further modified to win passage. Sen. Richard Blumenthal, D-Conn., has called it "dead on arrival" in that chamber.