HARRISBURG — Pennsylvania’s Democratic Sen. Bob Casey returned to the state on Friday to hammer the Republican health care bill in the U.S. Senate, saying it poses a foundational retrenchment of Medicaid that could have a dramatic, long-term effect on American society.

Casey, who is running for re-election for a third term next year, warned that it could also mean coverage losses for people with employer-sponsored insurance, in addition to those covered by Pennsylvania’s $30 billion Medicaid program, a federal-state partnership.

“If they do to Medicaid what they’re trying to do, it’s not just a health care adverse outcome, we will be a different country, we’ll be a different society, because we won’t be taking care of people that most of us believe we should take care of,” Casey told reporters in the state Capitol after he led a rally against the bill.

“This will change our country radically. That’s why no one has attempted to do to Medicaid what they’re trying to do now,” Casey said.

The bill’s payoff for the decimation of Medicaid, Casey said, is to deliver a tax cut to the “super rich.”

Senate Republicans released the long-anticipated bill Thursday after weeks of closed-door meetings searching for middle ground between conservative and centrist senators in an effort to make good on promises to dismantle former President Barack Obama’s signature health care law.

The bill could come to a vote as early as next week. Pennsylvania’s Republican U.S. Sen. Pat Toomey, who helped write the bill, said he is likely to vote for it, in part because it puts Medicaid on a sustainable path that will make it more affordable in the future.

Casey and others say the bill poses a bigger threat to Pennsylvania’s health care system than many other states, partly because of Pennsylvania’s relatively generous Medicaid program and partly because of its relatively older and costlier population.

Also opposing the bill in the hours after it emerged were Democratic Gov. Tom Wolf, the Hospital and Healthsystem Association of Pennsylvania, the Arc of Pennsylvania, the AARP of Pennsylvania, children’s advocacy groups and labor unions.

Nearly 2.9 million Pennsylvanians are on Medicaid, or almost one in four Pennsylvanians, and about 1 million more than a decade ago, according to state figures.