The health care reform package meant to be President Donald Trump’s signature act increasingly looks like it would devastate his home state. The American Health Care Act would hollow out care, cost jobs and put the health of the vulnerable at risk. But it’s a last-minute amendment introduced into legislation in the House of Representatives by two upstate Republicans, Chris Collins and John Faso, that would do the most damage, especially to wealthier suburbs like Long Island.

Sixteen states make counties pay a portion of Medicaid costs, with the rest coming from the states and the federal government. Fifteen of them somehow escaped being threatened by this train wreck. However, Reps. Collins and Faso, whose regions would likely benefit from the change, agreed to shaft the rest of New York in return for their votes. Trump and House Speaker Paul Ryan need every vote possible to get the bill over the finish line, so they agreed to go along.

This amendment would let New York counties, which pay 13 percent of Medicaid costs, off the hook. But it doesn’t provide a penny more to the state. Collins and Faso, who are only interested in their districts, aren’t worried, though. They say the state can just pony up the extra $2.3 billion a year in revenue starting in 2020 or find magical savings.

Faso argues that the scheme would allow counties to reduce property taxes, even though the amendment makes no such demand. And how likely are those tax cuts to happen? Meanwhile, Albany would make up the lost county share from taxpayers, or not at all. But Gov. Andrew M. Cuomo says the state will not make up the difference, and State Senate Majority Leader John Flanagan agrees. The only other possibility is that Medicaid spending would drop dramatically.

The $2.3 billion-a-year cut from this amendment would be in addition to cuts of about $2.4 billion a year in Medicaid to New York that were already in the American Health Care Act, for a total of $4.7 billion. That amount cannot be found in the state’s loose-change drawer. The resulting cuts would be devastating to patients, as well the medical professionals and institutions that provide care. About 50 percent of Medicaid spending in New York goes to long-term care of elderly and disabled people. This plan would cut Medicaid payments for nursing home patients by $400 million a year.

The Trump-Ryan bill would likely cost about 1 million New Yorkers their Medicaid coverage, and hospital experts and advocacy groups say it would drive hospitals working on the margins out of business. The Catholic Health Association of the United States opposes the amendment. Cuomo said it could undermine the merger of Southampton Hospital and Stony Brook Hospital and close many Long Island nursing homes.

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The bill is still short Republican votes. If Reps. Lee Zeldin, Peter King and Dan Donovan vote no, it will likely die. If they support the amendment, they will be to blame for the personal and fiscal chaos.

Deals have to be made to get legislation passed, and that certainly was the case with Obamacare. But the idea that New York Republicans from Trump on down would act so cravenly against the best interests of the Empire State just to notch a political win is unacceptable. — The editorial board