One of Donald Trump’s central campaign promises was that he would replace Obamacare with a system that provided “insurance for everybody.” He moreover promised that he would not cut a cent from Medicare and Medicaid, the programs that provide coverage to older and lower-income Americans. He even got angry when other candidates promised not to cut Medicaid, because that was his thing, not theirs:

I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me. — Donald J. Trump (@realDonaldTrump) May 7, 2015

Unfortunately for the working-class Rust Belt voters who provided the crucial votes that made him president, Trump’s new thing is cutting Medicaid. The American Health Care Act, which he and other Republican leaders are on the verge of pushing through the House (Update, 2:41 p.m.: The bill passed on a 217–213 vote), would eliminate a total of $880 billion in the program’s funding between now and 2026. As a result, the Congressional Budget Office projected in March, 14 million people would lose Medicaid coverage. And while the current version of the AHCA hasn’t been reviewed by the CBO, if anything, it will make things even worse for voters than the first one did because it also eliminates Obamacare guarantees of “essential benefits” coverage and coverage for pre-existing conditions. Maybe hospitals will start accepting “Hillary is a bitch” T-shirts as barter payment?