CLEVELAND (AP) — The Cleveland Clinic’s chief executive says he’s opposed to the Republican health bill in the U.S. Senate because he believes it will burden hospitals, throw people off insurance and fail to address the rising cost of health care.

Dr. Toby Cosgrove said on Monday he believes doctors and insurers weren’t given enough time to assess the impact of the proposed legislation, which was revised overnight to win over wavering GOP senators.

“The bill is changing even as we’re about to vote on it later this week,” Cosgrove said. “It’s really unreasonable to expect all the various players to understand what we’re signing up for.”

Republicans have pinned their hopes to scrap former President Barack Obama’s health reforms on a measure by GOP Sens. Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana.

The bill, called Graham-Cassidy, would eliminate Obama’s expansion of Medicaid and subsidies the law provides to millions of people to reduce their insurance costs. Instead, block grants would be given to states with few strings on how the money would be spent.

Cosgrove said the bill would flood hospitals with patients unable to make payments and create 50 different networks for each state, putting stress on health care systems and making them less efficient. He said it fails to address underlying problems with health expenses, foremost among them the burden of an aging population.

“It’s easy to just move money around and take people off coverage, but it’s not going to deal with the rising cost of health care,” Cosgrove said.

Cosgrove said a bipartisan effort is needed to streamline health systems and address rising drug prices, excessive regulation and a lack of universal electronic medical records. He said he “cannot believe” Senate Republicans are trying to scrap Obama’s health law again after prior attempts during President Donald Trump’s time in office failed.

The bill faces an uphill battle. Facing uniform opposition from Democrats and doubts from key GOP senators, top Republicans amended the measure on Sunday to add $14.5 billion for states and ease coverage requirements. With a slender 52-48 Senate majority, Republicans will lose if just three GOP senators stray from the bill.

A spokesman for Republican Sen. Rand Paul, of Kentucky, said Monday that he remains opposed to the revised bill. GOP Sen. John McCain, of Arizona, opposed the bill’s initial version, and Republican Sen. Ted Cruz, of Texas, said Sunday he was against it. Republican Sen. Susan Collins, of Maine, appeared to lean against it, and GOP Sen. Lisa Murkowski, of Alaska, remained undecided.

Collins, Murkowski and McCain killed the last Republican effort in July.

A vote must occur this week for Republicans to prevail with their narrow Senate majority. On Oct. 1, protections against a Democratic filibuster, bill-killing delays that Republicans lack the votes to overcome, will expire.

Cosgrove has been a consistent critic of Republican efforts to repeal the Democratic former president’s health reforms in the past few months. He was an adviser on the current Republican president’s Strategic and Policy Forum until the group disbanded in August.

The Cleveland Clinic is among the largest health systems in the country, with about 51,000 employees. Besides its sprawling main campus in Cleveland, it has 10 regional hospitals, outpatient sites elsewhere in Ohio and branches in Canada and Abu Dhabi.