WASHINGTON – States estimate that proposed changes to Medicaid would cost them $50 billion in federal aid over the next five years, nearly four times the administration estimate, according to a Democratic congressional report.

Maine would lose $36 million in the coming fiscal year alone.

The nation’s governors have vigorously protested the proposed Medicaid changes. They say it would amount to a shift in costs that would have to be made up by the states.

The rules cover myriad services. For example, one proposed regulation would limit Medicaid reimbursement to public hospitals to no more than the cost of providing a particular service. Another would prohibit billing Medicaid for the costs of medical interns and residents.

Federal officials said the changes are designed to ensure that providers don’t bill the nation’s health care program for the poor for more than the costs of providing care and that states pay their fair share of the program.

The report was prepared by the Democratic staff on the House Committee on Oversight and Government Reform.

“At a time when our economy is slowing, jobs are leaving and states, including Maine, are facing significant budget deficits, this is not the time for the administration to be cutting Medicaid,” said U.S. Sen. Olympia Snowe of Maine in a statement Monday. Snowe is a senior member of the Senate Finance Committee.

Snowe and others are urging the administration to reconsider the regulations. Maine has joined three other states – Maryland, New Jersey and Oklahoma- in filing a lawsuit against the federal government over the new Medicaid rules.

Overall, the federal government will spend more than $1.2 trillion on Medicaid over the next five years. The administration projects that if all the changes it seeks were enacted, the federal government would save about $13 billion over those five years.