Since 2008, the story of American politics has been the Republican Party's long, vicious struggle to regain power and cling onto it by whatever means necessary.

The Tea Party wave election in 2010 brought a new legion of far-right ideologues into Congress. That same year, Republicans won control of statehouses across the country, which gave them the ability to redraw electoral maps in the wake of the census. Around the same time, Republicans began passing new laws that make it even harder for poor people, young people, and people of color to vote. And they expanded a decades-long war on unions, traditionally a wellspring of Democratic support and cash.

DC gridlock soon became normalized as once-fringe conservatives consolidated control of the Republican Party. In 2013, right-wing elements of the GOP briefly shut down the government because they objected to funding for the Affordable Care Act (ACA). That same year, House conservatives launched an ultimately successful campaign to derail immigration reform—again.

In the Senate, Mitch McConnell, then the minority leader, did everything he could to block Democratic bills. After the Republicans retook the Senate in 2014, McConnell became majority leader. That helped him engineered his most audacious act of blockage ever, when he refused to even hold hearings on Barack Obama's pick to replace Antonin Scalia on the Supreme Court. That shockingly partisan gambit paid off—like a lot of Republican gambles—when Donald Trump successfully nominated Neil Gorsuch to the court after winning the presidency.

So how are Republicans choosing to exercise this power they've spent so much time and effort acquiring? What are the ends that make their means necessary? With the unveiling of the Senate's version of healthcare reform on Thursday, America got reminder of their overriding goals: Cut taxes for the rich, and make life as miserable as possible for poor people.

There's a little more to it than that, of course (the bill would also defund Planned Parenthood for a year), but really that's what this boils down to. Arguably the most important part of Obama's signature healthcare law was Medicaid expansion, which gave millions of people (most of them poor) access to insurance and healthcare and may have even improved the economy. "National, multi-state, and single state studies show that states expanding Medicaid under the ACA have realized budget savings, revenue gains, and overall economic growth," wrote the nonpartisan Kaiser Family Foundation in a February assessment of studies on the subject.

The new Senate bill, like the bill the House passed last month, would roll back that Medicaid expansion, though the Senate version would do so more slowly, spreading the cuts out between 2021 and 2024. Both versions would also place new funding restrictions on Medicaid, forcing states to make hard choices about cutting services or raising taxes—or both. According to the nonpartisan Congressional Budget Office (CBO), the House bill's changes to Medicaid alone would lead to 14 million fewer people having insurance by 2026. (The CBO has yet to score the Senate version.)

The savings generated by taking away insurance from the poor, disabled, and addicted will be mostly eaten up by a variety of tax breaks for the rich.

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Healthcare reform is the only piece of major legislation the Republican Congress has considered so far. This is telling. Lawmakers could have tried to tackle tax reform, or they could have followed Trump's lead and pushed for infrastructure spending, which was previously opposed by conservatives but is broadly popular across America. They could have even considered passing laws related to immigration or abortion, issues that remain very important to the Republican base.

Instead they chose to take on healthcare, rushing through a shockingly unpopular bill with the minimum possible amount of debate. Even by the low standards of the 21st century, this has been a cynical process. Republicans have complained about high insurance premiums under the Affordable Care Act, but their bill will only lower premiums by making insurance less generous.

Meanwhile, Trump doesn't seem to know or care about the bill he has endorsed repeatedly and in public; the healthcare reform he's been the most vocal about, letting insurers sell across state lines, isn't in either version of the bill. Libertarians who wanted the ACA's structure scrapped entirely have been ignored. Other ideas that have percolated on the right, like universal catastrophic coverage, were never considered seriously by Republican legislators.

Of course, more complicated plans, or proposals that cater to the populist wing of Trump's base, would require actual compromise. But Republicans clawed their way to control of the government by refusing to do just that—by denouncing any deviation from anti-government orthodoxy as socialism or worse. The closer they got to winning, the more their visioned narrowed—in 2015, far-right conservatives overthrew House Speaker John Boehner for being insufficiently inflexible. In March, that same group of diehards successfully brought down the first draft of this same bill for not doing enough to wipe out the Affordable Care Act.

Republicans wouldn't have taken over the White House and Congress without such a pure, crusading spirit. It fires up their base and forces politicians to toe the conservative line lest they face primary challenges from the right. Rage at Obama and the Democrats may have poisoned American politics for a generation, but it worked. The Republicans won.

But you can't govern on rage. Well, you can, and we're finding out what that looks like right now. So far, it's pretty fucking ugly.