ST. PAUL — State officials are warning that Republicans’ latest health care bill in Congress could have dire effects in Minnesota.

The fate of the GOP’s effort to repeal and replace President Barack Obama’s health care law is still up in the air. The Senate left for recess without voting on a bill after the Congressional Budget Office estimated it would cause 22 million people to lose coverage.

Minnesota’s top health care regulator said Wednesday changes to Medicaid funding could cost the state $2 billion in the first 18 months. Department of Human Services Commissioner Emily Piper also says it would eliminate almost all funding for a low-income health care program called MinnesotaCare.

Gov. Mark Dayton says that would be “catastrophic” for the state’s budget and its services.