At last, the Republican Party's long-promised sparkling alternative to the Affordable Care Act has arrived, and preliminary reports suggest that new proposal improves significantly upon existing law, providing cheaper, more affordable care to millions of Americans across the board and ensuring that... who are we kidding? It's a disingenuous, regressive, and cruel proposal that will make it even more difficult and more expensive to be poor in America.

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House Speaker Paul Ryan's plan, which you can read here, makes two key changes to the Affordable Care Act's scheme. As succinctly explained by the New York Times' Margot Sanger-Katz, the ACA expanded Medicaid to provide coverage for more lower-income Americans, and created a tax credit based on income to make insurance more affordable for middle-income Americans. RyanCare, as the Republicans' proposal is now known in my household, absolutely guts these provisions, slashing Medicaid funding for "able-bodied adults" and introducing a tax credit based on age that recipients can use to pay for insurance.

Notice the difference? The purpose of the Affordable Care Act is to—surprise—make healthcare affordable to those who otherwise couldn't pay for it. RyanCare, by contrast, doesn't even pretend to give a shit what happens to poor people. When the proposal (misleadingly) grouses about the injustice of providing Medicaid coverage to "able-bodied adults," it pointedly ignores the fact that said adults had no coverage before the ACA. Similarly, tying benefits to age isn't inherently irrational, since older people tend to incur higher healthcare costs. But eliminating the means test callously ignores what I thought was one of the foundational tenets of life in a developed democracy, which is that poor people shouldn't die because they can't pay for healthcare. America, your legislature apparently does not feel the same way.

The Affordable Care Act was the federal government's long-overdue first shot at bringing the skyrocketing costs of medical care in line with millions of Americans' diminished ability to keep pace. Was it perfect? No, no it was not. Does that mean that the rational response is to shrug, pick up another Ayn Rand novel, and quit trying altogether? Only if you're Paul Ryan, whose concern for the plight of lower-income American stops the moment he takes office, after which, nope, he's never even heard of them, thanks for stopping by.

No word yet on whether Speaker Ryan plans to hold town halls during the upcoming congressional recess or, like so many of his Republican colleagues, will be busy doing very important things other than listening to his furious constituents. Between this proposal and his hilarious track record at these things, though, it will hardly be a surprise if he chickens out.

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