Thus far our two United States senators have been fairly silent on the health care maelstrom taking place in that chamber of Congress. They shouldn’t be. Like many states, Alabama — where 37 percent of the population is low income — stands to pay a steep price if sought-for changes are made, particularly to Medicaid. The American Health Care Act (AHCA), which was passed by the House of Representatives in May and later described by President Donald Trump as being “mean,” takes a sledgehammer to federal Medicaid funding.

It does so by eventually reducing federal spending on the program by $834 billion. A significant reduction, to say the least. The AHCA would repeal and replace the Affordable Care Act — “Obamacare” — but would do so at great cost to many Americans. Particularly hard hit would be states with high Medicaid enrollment — states that, in many cases, have Republican majorities.

Medicaid is a program jointly funded by individual states and the federal government, with the federal government traditionally shouldering the brunt of the burden. For example, in Alabama the state pays around 30 percent of its overall Medicaid costs and the federal government covers the remainder. In other words, for every $1 Alabama spends on Medicaid, the federal government matches it by $2.35.

Reductions and limits imposed by the AHCA, if it were implemented, would mean states would be required to drastically increase their share of spending to maintain Medicaid benefits and services. In poor and already cash-strapped states such as Alabama, this would be devastating.

Medicaid is an important program. Nationwide, 75 percent of all nursing home residents are dependent on Medicaid. Fifty percent of all babies born in the U.S. are covered by Medicaid. Forty percent of all kids in the U.S. get access to health care because of Medicaid, including those with Down syndrome and cerebral palsy. Around 9 million disabled or blind Americans are dependent on the program. In the fight against opioid abuse it’s been a lifeline to many seeking assistance breaking free of addiction.

Statewide, out of Alabama’s 4.8 million residents, around 1 million receive Medicaid benefits. Throughout Alabama, Medicaid covers for these enrollees a plethora of services, from dental care and physician and outpatient services to hospital stays and long-term care. Sixty-six percent of adult and child Medicaid enrollees in Alabama are in families with at least one worker.

Although Medicaid is geared toward low-income individuals, it’s critical to the overall access to quality health care for all Alabamians. Why? Because for many hospitals and clinics, reductions in Medicaid patients and funds would drastically affect their bottom lines and lead to cuts in services and staffs — which means that as hospitals close and doctors leave the state, those of us with health insurance coverage would suffer right along with those who have been cut off from Medicaid.

The cuts would be particularly devastating to pediatric care in the state. More than half the children who are treated at the two largest pediatric hospitals in the state, Children’s of Alabama and USA Children’s & Women’s Hospital, rely on Medicaid for their health care coverage. Also, many pediatric subspecialists don’t have enough patients with commercial insurance to keep their practices afloat; a loss of Medicaid patients could force these doctors to close their offices and seek a financially sustaining practice in another state.

Equally devastated would be rural hospitals and clinics that rely heavily on Medicaid funding.

That’s why what takes place in the Senate with regard to health care is so important. As the country has witnessed over the past few months, health care is not a simple issue. It’s a complex and complicated issue that requires careful thought, understanding and patience from our leaders, not haste, indifference and thoughtlessness. Unfortunately, the latter is what the American public seems to have been getting thus far. The nation deserves better. Alabama deserves better.

During the 2016 election period we saw in campaign ad after campaign ad how much Sen. Richard Shelby loves traveling throughout the great state of Alabama, down the backroads and byroads “listenin’” and “talkin’” with Alabamians wherever he goes. Also, we learned how valiantly and heroically he stood up to President Barack Obama on behalf of the people of Alabama, shielding us from all the harm and nefarious plans he said President Obama had in store for us.

With his Senate seat up for grabs due to a special election this year, “Big Luther” Strange is telling us he’s a lot like Senator Shelby, a simple man of the people, willing to stand up for, and defend, the people.

Yet with an issue so important and crucial to the well-being of all Alabamians, senators Shelby and Strange have been absent among the people and mute on how they will defend the interests of the citizens of Alabama when it comes to health care. They have held no public meetings on the issue, and have been strangely silent on the various legislative proposals that have been circulating in the Senate. That’s not good, because a lot is at stake.

For those with sound and secure health care coverage, the tempest that is taking place in the halls of Congress and throughout America may seem to be much ado about nothing or grossly overblown. But reductions and cuts proposed thus far in the repeal and replacement of Obamacare won’t just affect the poor, particularly in Alabama. They have the potential to affect us all.