Left in the smoldering ruins of the GOP's humiliating failure to repeal and replace Obamacare — the House a week ago lacked the clout even to call a vote — is a fear that the 30 million American children who might have become collateral damage of that rushed effort remain vulnerable.

True, there’s no sign the GOP wants to go anywhere near another health-care reform anytime soon; the belly flop still stings. But this doesn’t preclude separate legislation in the future by those who still have their sights on cutting Medicaid, changing the insurance program for the poor from an entitlement with open-ended federal funding to one with capped funding.

As it stands, the current program is a deficit-driver, with the federal government paying a greater share of higher state costs and expanded coverage. In 2016, Medicaid amounted to $368 billion in federal funding; this is expected to rise to $616 billion by 2026.

At some point, Congress will have to address this entitlement. When it does, it should look to avoid the threat to children it planted in its stymied American Health Care Act, which proposed changes that would have cut Medicaid spending 25 percent by 2026.

Until now, debate over Medicaid has largely focused on its effect on adults. But Medicaid is the largest insurer of this nation’s kids. So a very real fear is that caps on spending, and the funding gaps they would create in the states, ultimately would crowd out funding for kids’ care.

This is particularly unfair because children (who have relied upon Medicaid for decades to grow up healthy or just grow up) were never the intended beneficiaries of the Medicaid expansion under the 2010 Affordable Care Act. It focused on adults.

That expansion, embraced in Ohio by Republican Gov. John Kasich as a way to save state dollars and provide compassionate treatment for those with serious health problems, has done the yeoman’s work of extending coverage under the ACA amid collapsing state marketplace exchanges and myriad other Obamacare flaws.

In 31 states that accepted it, the Medicaid expansion provided coverage for 11 million people. But maintaining this expansion is costly. A new study by the nonpartisan Kaiser Family Foundation found that it would take cuts equivalent to one-quarter of some state’s education budgets to keep this coverage without raising taxes. States would have to choose between spending more on Medicaid for needy adults and taking dollars from other services.

But poor children also rely upon Medicaid. As do the medical centers that treat them; nearly 53 percent of patients at Nationwide Children’s Hospital have Medicaid coverage, and 1.2 million children in Ohio are covered by the program.

These dollars are a cost-effective investment. While children make up more than 40 percent of the Medicaid population, kids account for only 20 percent of Medicaid spending. Kids are typically healthier, but this also reflects that these Medicaid benefits very specifically provide for cost-saving preventive care, such as immunizations and well-child visits.

In Ohio, home to a number of outstanding pediatric hospitals, the looming threat to the children they serve has created worry. This past Sunday, the Ohio Children’s Hospital Association took out newspaper ads statewide to send Congress an open letter. It begins: “Stop playing politics with kids’ health care!”

As Congress regroups, it is imperative for Republicans and Democrats to work together to ensure that any changes to the ACA or Medicaid protects funding for the health of our children. Politicians should follow the admonition of physicians: First, do no harm.