Hawaii lawmakers advanced a bill on Wednesday that would ensure benefits under former President Barack Obama’s Affordable Care Act are preserved under state law in the event Republicans in Washington, D.C., repeal the law they have spent seven years fighting.

The vote in favor of House Bill 552 by the state Senate Commerce, Consumer Protection and Health Committee comes as the U.S. House of Representatives prepares for a floor vote today on a Republican health care overhaul led by Republican House Speaker Paul Ryan and backed by President Donald Trump.

State officials have been particularly concerned about 110,000 adults who are covered under the Affordable Care Act’s Medicaid expansion program and comprise about one-third of the state’s total Medicaid population. The state could face a shortfall of $230 million in federal dollars if the federal expansion program is phased out.

There are also about 19,000 Hawaii residents who receive health insurance under the federal health insurance exchange who lawmakers are working to ensure still have coverage options in the event the exchange is discontinued.

“This is a bit of a Christmas tree bill because I think it is important with the uncertainty that we get as many ideas and possibilities to conference to see where we go from there,” said Sen. Rosalyn Baker (D, West Maui-South Maui).

She emphasized that the specifics of the bill would likely evolve depending on political developments at the federal level and that in the end the measure may morph into only a working group if Congress is still debating health care.

While Trump promised a speedy repeal and replacement of Obamacare, the passage of what is now being called “Trumpcare” could prove more difficult than anticipated.

As of Wednesday, national news outlets were reporting that the Republican-backed health care plan was in trouble in the House as Trump and Republican leaders worked to whip up enough votes.

“I’m sort of believing in the final analysis: What we are going to end up with is a working group to sort of address these things because it is very complicated. Yes, who knew that health care was so complicated?” said Baker, paraphrasing Trump.

House Bill 552 contains many elements of Obamacare. It would forbid health insurance companies from excluding people from coverage based upon pre-existing conditions, and would extend dependent coverage for adult children until the age of 26. The bill also would retain some form of the health insurance mandate that requires taxpayers to have health insurance throughout the year or pay a penalty. The measure also would forbid insurance companies from charging more for premiums or contributions based on someone’s gender.

The measure has mainly attracted comments and suggestions from government departments, such as the Department of Human Services, Department of Labor and Industrial Relations, and Department of Taxation as officials try to sort through how enacting the federal reform within state agencies would play out.

However, advocates for universal health care have criticized the measure, saying that an overhaul of the health care system is needed instead.

“Hawaii is facing a health care crisis, but this bill will not address the root cause of that crisis, which is the private insurer system,” the Community Coalition for Hawaii Universal Healthcare through Comprehensive Planning wrote in testimony on the bill. “Hawaii needs universal health care, and indeed that is Hawaii’s official state health policy goal — universal coverage.”

The alliance said the measure would “preserve the current system whereby private insurance dominates health care, creating undue complexity and unneeded demands on medical providers that result in soaring costs that could easily be eliminated.”