The proposed Republican Obamacare repeal and replace bill would cost Iowa nearly $60 million in the first year, but the state would gain money later. That's the finding in an analysis by the federal Centers for Medicare and Medicaid Services. The analysis shows Iowa losing $59 million in 2020. By 2026, the state would pull in $5 million more than the current law would provide. The bill could come up for a vote in the Senate this week.