It has sometimes been overlooked that whites make up a solid plurality, 41 percent, of Medicaid recipients; 22 percent of recipients are African-American and 25 percent Hispanic. In the four pivotal 2016 states that supported Trump I referred to earlier, whites are the majority of recipients, ranging from 58 to 67 percent.

Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities, described some of the AHCA changes in Medicaid in an email.

Beginning in 2020, Solomon wrote,

states can freeze enrollment and only cover the “grandfathered” enrollees who were enrolled on 12/31/19. The block grant option allows states to cut eligibility. The only requirement would be to cover pregnant women and children under age 6 with incomes under 138% of the poverty line, and children 6 to 18 below the poverty line.

Along similar lines, Matthew Fiedler, a Brookings fellow, wrote me:

The two most important Medicaid provisions under the AHCA are: (1) cutting federal funding for covering the ACA Medicaid expansion population; and (2) implementing a “per capita cap” that would limit the total amount of federal funding states could receive per person they enroll. Both provisions would give states very strong incentives to curtail eligibility, but neither would directly require states to do so.

Those placed at highest risk under these provisions, according to Fiedler, are “non-elderly adults with incomes below 138 percent of the poverty, particularly those without kids.” Many of these “childless adults” — adults without dependent children — are not actually childless but aging parents whose children are grown and do not live at home.

Just as the tax changes in the Republican bill flow to the rich, so do the health care benefits.

Howard Gleckman, a senior fellow at the Tax Policy Center, found that cuts in Medicaid and new health care tax subsidies would have upwardly redistributive consequences:

Those making less than $10,000-a-year would lose an average of about $1,400, or nearly one-third of their income — under the AHCA relative to the ACA. Middle-income households, those making $50,000 to $75,000, would see little change — an average increase in net government transfers of about $60. However, those making $200,000 or more would receive an average net increase in government support of $5,640, or 1.1 percent of their income.

Gleckman explained that the

decline in well-being for low-income people would result from the AHCA’s proposals to cut the federal contribution to Medicaid and its move to eliminate cost-sharing subsidies for lower-income households that buy non-group insurance, thus raising their deductibles and co-pays.

In March, the Congressional Budget Office evaluated an earlier version of the legislation and estimated that 24 million people would lose coverage by 2026. Most experts believe that if something like the House bill becomes law, more than 10 million people, and quite possibly many more, will lose coverage.

The provisions of the House bill for those with pre-existing conditions are deliberately ambiguous. Will Doran, reporting for Politifact.com, noted that while insurers would “have to provide access to coverage for people with pre-existing conditions,” the measure “says nothing about the rates of that coverage.” As a result, the law would

allow for people with pre-existing conditions to be charged more per year for their insurance coverage — possibly to the tune of thousands or even tens of thousands of dollars more per year.

The American Medical Association opposes the legislation, contending that it would

result in millions of Americans losing their health care coverage and could make coverage unaffordable for people with pre-existing conditions.

From another vantage point, one with political significance, maps created by the Kaiser Family Foundation show how individuals of different ages and incomes would fare if the AHCA replaces Obamacare.

The affluent come out ahead. Older voters with modest incomes — a core element of Trump’s support — would be penalized, paying more for health coverage in almost every section of the country.