Congressional Republicans have “declared war on New York,” an angry Gov. Andrew M. Cuomo said Tuesday, referring to a proposed amendment to a federal health care bill that would shift New York’s Medicaid costs from its counties to state government.

Republicans countered the change would free counties from a state-mandated burden they have borne for five decades, to the detriment of local taxpayers, particularly upstate. Rep. John Faso, a Capital Region Republican, said Cuomo should “man up” and have the state take responsibility for Medicaid as it should have years ago.

The amendment, crafted by Faso and Rep. Chris Collins (R-Buffalo), was part of last-minute tinkering with the proposed American Health Care Act. The bill is championed by the GOP and President Donald Trump as the replacement to “Obamacare.”

With the first vote of a multipronged effort scheduled Thursday in the U.S. House of Representatives, GOP leaders added the provision to try to shore up support within their own party. One Republican lawmaker who initially opposed the health care bill, Utica-area Rep. Claudia Tenney, said she now will back the AHCA.

Supporters pointed out that New York forced local governments to pick up a larger share of Medicaid than any other state and the new provision would put New York more in line with others.

But Cuomo called the proposal a product of the “radical right” and said Collins and Faso were more beholden to Speaker of the House Paul Ryan (R-Wisc.) than their own constituents.

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Cuomo said the change would result in a $2.3 billion funding loss for the Medicaid program upstate and on Long Island. The provision excludes New York City because it imposes its own residential income tax.

“My greatest fear from last year’s election has actually come true, which is you would have a rabid conservative ideology in Washington that would tell New York to ‘drop dead,’ and that is exactly what is going on,” Cuomo said at a news conference in Manhattan, flanked by health care and union leaders.

Cuomo, a Democrat, said hospitals and nursing homes “are going to close” because the state won’t be able to make up the $2.3 billion difference.

Cuomo refrained from criticizing Trump — declining to refer to him by name, even when pressed — who has been pressuring Republicans to support the proposal. Instead, the governor focused on Ryan, Collins and Faso.

“What happened to putting people before your politics?” Cuomo said. “Rather than swearing allegiance to the Ryan radical right, why didn’t they think of representing the people of their district? Why didn’t they think about the oath that they took and put their politics aside?”

Faso said in an interview that of the $9 billion in Medicaid that local governments spend nationwide, more than $7 billion occurs in New York because of the burden it imposes on counties.

County governments in New York once picked up 25 percent of the statewide Medicaid costs, but that has been reduced to about 13 percent by a cap on local share. Nonetheless, Faso said it’s a burden that has been “killing” property-tax payers in New York for five decades.

“If governors in 49 other states can take responsibility, I’d ask him to man up and take responsibility in New York,” Faso said of Cuomo.

Faso, a freshman from Kinderhook, also took a swipe at the billions of dollars Cuomo has spent on promotional ads, roadside signs, and targeted statewide development projects.

“To think that a state that has money for a Buffalo billion and Brooklyn billion and a Bronx billion and money for signs on the highways that violate federal law and money for corporate welfare and money to advertise New York is open for business when it isn’t — to think it doesn’t have money to trim is ludicrous,” Faso said.

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Rep. Lee Zeldin (R-Shirley) said the House amendment would be a “jackpot” for Suffolk County homeowners, calling it “the single greatest act of fiscal relief ever provided to the County of Suffolk and its taxpayers.”

However, State Senate Majority Leader John Flanagan (R-East Northport) expressed a “certain amount of skepticism” about the proposal, wondering if it would work to actually reduce taxes or merely switch the tax-collection agency.

“If nothing happens to the taxpayer at the end of the day” to reduce taxes, he’d oppose the idea, Flanagan said.

New York City Mayor Bill de Blasio, a Democrat, said the House measure would “undermine hospitals.”

Democrats in the Nassau County Legislature called for a report on the possible local impact of the planned repeal and replacement of Obamacare.

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“We need to know how gravely Nassau County residents will be impacted by this,” Nassau Legis. Carrié Solages (D-Elmont) said at a news conference in Mineola.

Nassau County Executive Edward Mangano’s administration said it was “monitoring the impact of the bill” as debate continues.

With Paul LaRocco and Matthew Chayes