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The Republican Medicaid reform proposal will cause up to 12 million poor Americans to lose health coverage and force many hospitals to close emergency rooms, according to a report by a Consumer Reports team working with the National Health Law Program. The report cites California as an example of what could happen if the GOP plan, which cuts projected spending by 36 percent, goes into effect. More than 280,000 people lost their health insurance when California cut projected Medicaid spending by 18 percent in the 1980's, and many emergency rooms, especially in poor areas, were closed due to lack of funds. A vote on Medicaid is expected in both the House and Senate later this week.