And it’s not just people on Medicaid who would lose coverage if Republicans got their way. While Republicans in Congress have not unified by a single alternative to Obamacare, a building block of virtually every proposal in circulation is to equalize the tax treatment of employer-sponsored insurance and individual insurance—which, in layman’s terms, means making it much more appealing for somebody who gets coverage on the job to buy coverage on his or her own. Typically these proposals would allow insurers selling individual coverage to continue some of their current practices, like charging higher premiums or refusing to cover certain services for people with pre-existing conditions, or offering coverage with serous gaps in benefits. Most experts believe such reforms would hike the cost of employer plans, as only sicker people remained on them, potentially creating a “death spiral” that would lead to fewer employers offering plans. (Even the more optimistic estimates assume erosion of employer-sponsored insurance.)

Note the difference in scale here. Nobody knows exactly how many people are giving up non-group policies because insurers are reacting to Obamacare regulations. But it's probably in the millions—and still substantially less than the number of people who would lose insurance if Ryan's proposal for Medicaid became law.

More important, though, look at the kind of change taking place. Almost everybody giving up a non-group policy today has the option to get new insurance either through Medicaid or one of the new Obamacare marketplaces. Some people will pay more for these policies, some will pay less, but everybody will be getting coverage that includes an array of "essential" benefits, limits out-of-pocket spending, and can never be taken away or limited because the policyholder gets sick. In other words, everybody ends up with comprehensive, stable insurance. It may not be the policy he or she has today. But the vast majority of people with non-group market don’t keep the same policy for more than two years anyway.

Under the Republican plan, by contrast, people losing employer insurance would end up in the dysfunctional, non-reformed individual market—the one full of confusing, junk policies that might not cover basic services like maternity or mental health or have huge gaps in coverage. And the people losing Medicaid? They would end up with … nothing at all.