Republicans in Congress are moving toward making good on a years-long promise to get rid of the Affordable Care Act. But in order to pull it off, they will need constituents to forget the original intent of repealing and replacing Obamacare.

They’ll also require the working poor, anybody older than 50, children, pregnant women, those with pre-existing conditions or disabilities, or anyone in a nursing home that receives assistance from Medicaid to accept the fact their healthcare is going to get a lot more expensive — or disappear completely.

The Better Care Reconciliation Act, which passed the House and the Senate is considering, has very little to do with healthcare other than repealing the “disastrous” and “imploding” ACA. The replacement portion — that happened when federal lawmakers decided to give huge tax breaks to the wealthiest Americans instead.

How much? Almost $600 billion to be redistributed from lower- and middle-class citizens to their well-off neighbors, healthcare conglomerates and insurance companies. Close to $1 trillion would be cut from Medicaid, which proponents of the legislation boast will cover the tax cuts plus help reduce annual deficits.

Instead of fixing Obamacare, legislators opted to cherry-pick the provisions they liked, discard the rest — and allow the number of uninsured Americans to reach either 49 million or 51 million, depending on which chamber’s bill prevails. Here in Kansas, which already had opted not to expand Medicaid under the ACA provisions and has foregone more than $1 billion in federal support, the situation will worsen. By 2025, Kansas will have foregone $21.4 billion in net federal outlays for Medicaid compared with states that did expand, according to the Kansas Hospital Association.

We remind our readers that more than half of the fewer than 400,000 Kansans receiving Medicaid assistance are children. Everybody in the program, regardless of age, would have the state making decisions about who is eligible and what is covered for their healthcare.

Patients won’t be the only ones facing reductions. A report from the Commonwealth Fund asserts Kansas acute care hospitals will see a 12-percent increase in uncompensated care and a 10.5-percent decrease in operating margins. With approximately one-third of Kansas hospitals on shaky financial ground, more closures would appear imminent.

Amanda Ballantyne, national director of the Main Street Alliance, a national network of small business owners, said: “Medicaid dollars will dry up fast, leaving states with gaping budget deficits they have cover by cutting eligibility or taking dollars from other line items. And small businesses and their employees will end up back where they started before the ACA — either uninsured and one illness away from financial straits, or insured and paying so much that they’re unable to hire, reinvest in their own business, or spend at other Main Street businesses.”

These are not sky-is-falling, doomsday predictions. They are realistic assessments backed up by the non-partisan Congressional Budget Office.

Thankfully, enough senators have voiced opposition that their version of the bill won’t get a vote until at least next week. While Sen. Pat Roberts, R-Kan., is satisfied the bill is a good one, his junior counterpart does not.

Sen. Jerry Moran, R-Kan., and one who has close and long-held connections to our region, said: “The Senate healthcare bill missed the mark for Kansans and therefore did not have my support.”

We appreciate Moran standing up against party leadership focused on giving more tax breaks to the wealthy than actually fixing problems Kansans and others are experiencing. We encourage him to continue demanding close attention be paid to the healthcare components of the “replacement” portion. That is supposed to be one of the objectives of this legislation.

Editorial by Patrick Lowry

plowry@dailynews.net