You can't blame Pennsylvanians wondering who Sen. Pat Toomey represents. He's a ring leader of the effort to replace the Affordable Care Act with a Republican proposal that would jeopardize the lives and livelihoods of thousands in this state. That suggests Toomey's allegiance lies elsewhere.

Perhaps it's with the Club for Growth, the pro-business group Toomey once headed, which pumped more than $5 million into his reelection campaign. "We are proud of our efforts and delighted with Pat's victory," a Club spokesman said. "He's the embodiment of a pro-growth fighter who has held firm to the principles of economic liberty while representing a blue state."

Well, the health care of many in that blue state will be in trouble if Toomey and Senate Majority Leader Mitch McConnell (R., Ky.) rescue their bill after the holiday recess. McConnell wants to use a legislative tactic requiring only a simple majority for passage, but the Republicans have just a two-vote majority and at least six were still opposed to the bill late last week.

There's a lot to dislike, especially the bill's impact on Medicaid. Gov. Wolf says the bill would cost Pennsylvania $2 billion in Medicaid funding it gained when enrollment was increased under Obamacare. A state facing a $3 billion deficit can't easily replace that money. Wolf wrote to Toomey in June, asking him to rethink his position. "For hundreds of thousands of Pennsylvanians, Medicaid is not a handout - it is a lifeline," the letter said.

Toomey accused Wolf of exaggerating and said any cut in the federal share of Medicaid funding was needed to rein in the program's costs. He suggested Wolf should find ways other than limiting eligibility to offset the cuts. "Why would [Wolf] threaten to throw these people off Medicaid unless he feels it's not worth it to provide Medicaid for them even when he can have it for less than half the cost?" asked Toomey.

He and his fellow Club for Growth members seem focused solely on cutting taxes. To do that, they want to put Medicaid on a skimpy budget, regardless of the consequences. But the consequences would be severe for Pennsylvania, which has one of the nation's largest populations of seniors. Many use Medicaid not only for health care but also for housing in nursing homes.

But it's not just older citizens who would be hurt if Medicaid is cut in a misguided attempt to repeal the ACA instead of fixing its flaws. Medicaid provides health coverage for children, pregnant women, and people with disabilities. Obamacare expanded Medicaid to include more of the working poor who couldn't afford private health insurance.

Then there's what the Pennsylvania Health Department calls the state's "worst public health crisis" - the opioid epidemic. In March, Toomey addressed the Senate and called opioid abuse a "scourge . . . that has not spared any area of Pennsylvania." But months later, he had no problem pushing a bill that would cut Medicaid funds used to fight addiction.

Without acknowledging the hypocrisy, but desperate to get his bill passed, Toomey said Thursday that more funds to combat opioid addiction would be put into the Senate health care bill. But that won't help the 22 million Americans who will lose coverage over time if the legislation passes. Pennsylvanians need to take time before the Senate returns from its holiday to let Toomey know they want him to represent them, not the Club for Growth.