How can any Republican with a shred of decency seriously participate in the Kabuki dance recently performed in the Senate, its purpose to dismantle the Affordable Care Act?

To a person they know, absent any ambiguity, that the least among us — some 16 to 30 million Americans — will, according to the Congressional Budget Office, lose their health insurance should just one of their proposed bills (was it five or six?) pass. Their efforts, knowing what it will mean to the lives of so many, are so breathtakingly outrageous and immoral as to verge on the surreal.

Meanwhile Trump continues to lobby for “Repeal and Replace,” insisting that the outcome will be a “beautiful thing.” The truth embedded in his words, his demeanor, is that he has not read a single bill and simply doesn’t care. He wants only to win. Something. Anything. That is the prism through which he views his presidency and his brand-driven life.

Meanwhile, as the Republican senators, who possess the best health care our nation can provide, cajole their caucus to do the wrong thing and call it the right thing.

According to the New York Times, there was taking place over three days, in Wise, Virginia, what is called a “Pop Up” health clinic offering free care, sponsored by the Remote Area Medical Expedition.

More than 2,000 poor people, many without much if any health insurance, or access, came. They camped out or slept in their cars, waiting for the gates to the county fairgrounds to open at 5 a.m.

Available were volunteer dentists, doctors, nurses, X-ray vans and technicians, optometrists, specialists in diabetes and lung problems. They arrived in wheelchairs, some pushed by their children; more than a few hobbled, leaning on well-used canes; others were missing teeth (one man explained he pulled his out with needle-nosed pliers). Many were examined and sent immediately to emergency triage needing a variety of medical interventions. It was a heart-wrenching array of humanity. Here. In America.

For those who had a semblance of insurance, most could not afford the co-payment or the cost of gas to get to a doctor. Many were only marginally employed. When Trump told them that coal was coming back, they believed him. ACA, he said, was broken, “a disaster,” they believed.

Meanwhile the Republican senators were crafting a repeal/replace, insisting that they had these people’s best interest at heart.

Keep in mind that Virginia was one of 19 states whose Republican governor and legislature refused to expand Medicare. Nationwide, hundreds of thousands could have benefited from the expansion at little or no cost to the states. Why Virginia refused is reprehensible in the extreme. The result of this refusal is not just an abstraction but is made manifest when one pauses to observe those who came to this free clinic.

Know that Medicaid/CHIP serves some 33 million children, funded by the federal government and the states. Medicaid also covers low-income pregnant women and finances one half of all births nationwide. It serves a large share of children with special health needs as well as financing more than 60 percent of the elderly in nursing homes. It affects children of color, reducing racial and ethnic disparities.

By definition, Medicaid is profoundly humane and acknowledges that there are those among us, for reasons that are profoundly complex, who live life on a precipice. If there is a program that we can point to and say this defines us, this is who we are, it is Medicaid.

We’ve seen the images of people in wheelchairs in the halls of Congress, panic written in their eyes. We’ve seen parents with their severely disabled children, desperate with anxiety. We’ve watched as some merely stand in silent protest as their legislators callously debate their tragic circumstances.

Of course we know that there but for the grace of our birth and personal journey go we.

Meanwhile, there are men and women in the chambers of Congress who behave as if they are detached from this abiding truth.

One final word: The just-christened aircraft carrier, the USS Gerald Ford, cost $13 billion and change.

— Chris Honoré of Ashland is a Daily Tidings columnist.