First, do no harm

In the six-plus years since the Affordable Care Act became law, Republicans have salivated over the prospect of doing away with Obamacare and put some dream alternative in place. “Repeal and replace,” they’ve said over and over and over again. Now, a united GOP Congress prepares to achieve its dream — passing a budget resolution to repeal the health care law, with an incoming President Trump eager to sign it.

Yet despite the law’s ample flaws and a supposed brain trust in the House, Paul Ryan and his crew still have no better option on the table. Instead, they have a fiction, “repeal and delay” — which would officially end federal subsidies for the program, but delay impact for even more years until the party comes up with . . . something.

Meantime, the prospect of repeal is a live threat to some 20 million previously uninsured Americans — 13 million of them children.

This includes many in Republican-led states like Ohio, where nearly 700,000 are now insured because of ACA-created Medicaid expansion.

In New York, the Cuomo administration estimates that ACA repeal would hammer the budget by at least $3.7 billion.

The Milken Institute estimates repeal of Obamacare could kill as many as 3 million jobs nationwide.

Meanwhile, nearly all Republicans say they intend to keep popular items like the ban on blocking people with preexisting conditions from getting insurance, or allowing individuals to stay on their parents’ plans until age 26 — two of the costlier parts of the law.

How would that be paid for? The silence is deafening, and pretty soon, hearing loss will no longer be covered.