Here's the big headline at Vox right now:

By picking Tom Price to lead HHS, Trump shows he’s absolutely serious about dismantling Obamacare

Apparently, up until now the intelligentsia wasn't quite sure that Republicans meant it the eighty thousand times they told us that their most important domestic policy goal was the end of Obamacare. They were just joking! It was an elaborate, sustained bit of performance art!

No, really, guys, Republicans were serious. Trump knew they were serious, and Trump's going for it, just as every other Republican who had a chance to win the party's presidential nomination would have gone for it.

From the Vox story:

Rep. Tom Price (R-GA), President-elect Donald Trump’s pick for health and human services secretary, already has a plan for how to abolish Obamacare.... Price ... is the author of the Empowering Patients First Act, one of the most thorough and detailed proposals to repeal and replace Obamacare. He’s the HHS secretary you’d pick if you were dead serious about dismantling the law. It would replace the law with a plan that does more to benefit the young, healthy, and rich -- and disadvantages the sick, old, and poor.... The biggest cut to the poor in Price’s plan is the full repeal of the Medicaid expansion, a program that currently covers millions of low-income Americans, which Price replaces with, well, nothing.

But even if Price's plan isn't enacted as he wrote it, whatever takes the place of Obamacare will cover fewer people, and will be especially hard on those who need healthcare most. That has Paul Krugman asking,

So here’s the question: how many people just shot themselves in the face? My first pass answer is, between 3.5 and 4 million.

That's Krugman's back-of-the-envelope estimate of how many Trump voters will be thrown off the healthcare rolls.

Greg Sargent writes:

I have obtained new numbers from the Gallup-Healthways Well-Being Index that suggest that a lot of poor and working-class whites -- who voted for Trump in disproportionate numbers -- have benefited from Obamacare, meaning they likely stand to lose out from its repeal (and even its replacement with something that covers far fewer people). ... Gallup-Healthways tells me that among whites without a college degree who have household incomes of under $36,000, the uninsured rate has dropped from 25 percent in 2013 to 15 percent now -- a drop of 10 percentage points. ... it now looks more likely that we’ll see a substantial rollback of the progress toward universal health coverage we’ve seen in the past few years. News organizations love to venture into Trump’s America to hear voters explain that Trump spoke far more directly to their economic struggles than Democrats did. Maybe now we’ll get more coverage of those inhabitants of Trump’s America who are set to lose their health care, too.

But if you're thinking that those voters will direct their anger at Trump and fellow Republicans when their healthcare is taken away, ask yourself: Were heartland whites angry at Ronald Reagan when he busted the air traffic controllers' union, a signal event in the decline of the American labor movement? No -- a few years later their votes contributed to a 49-state landslide for Reagan. Did heartland whites rail at big banks after the 2008 financial crisis? No -- Tea Party members denounced President Obama and his fellow Democrats for alleged spending excesses and for Obamacare.

The pattern always holds. In Strangers in Their Own Land, Arlie Russell Hochschild writes about Tea Party supporters who refuse to direct their angry at the very people who do harm to them. This is from Nathaniel Rich's review of the book in The New York Review of Books:

The paradox that most baffles Hochschild is the question of environmental pollution. Even the most ideologically driven zealots don’t want to drink poisoned water, inhale toxic gas, or become susceptible to record flooding. Yet southwestern Louisiana combines some of the nation’s most fervently antiregulatory voters with its most toxic environmental conditions.... Hochschild discovers a walking personification of these ironies in a Cajun oil rig engineer named Mike Schaff. In August 2012, Schaff was entering his home in Bayou Corne, about seventy miles west of New Orleans, when he was jolted by a tremor. His concrete living room floor cracked apart. The sound, said a neighbor, was like a “garbage truck had dropped a dumpster.” More than a mile beneath the bayou, a Houston-based drilling company named Texas Brine had drilled into a vast salt dome, ignoring warnings from its own engineer.... Texas Brine drills for salt, which it sells to chlorine manufacturers, but other companies had used sections of the salt dome to store chemicals and oil. Texas Brine drilled too closely to an oil deposit and the structure ruptured, sucking down forest and causing seismic damage to the homes of 350 nearby residents. Officials began referring to Schaff’s neighborhood as the “sacrifice zone.” Texas Brine refused to take responsibility for the accident.... Four years later the sinkhole is 750 feet deep at its center and has grown to thirty-five acres. Methane and other gases bubble up periodically. Residents who defied evacuation orders avoided lighting matches. ... [Schaff] marched on the statehouse, wrote fifty letters to state and federal officials, granted dozens of interviews to local, national, and foreign press. When state officials claimed they had detected no oil in the bayou, he demanded that the EPA check their work. But Schaff continued to vote Tea Party down the line. He voted for the very politicians who had abetted Texas Brine at every turn, who opposed environmental regulation of any kind. He voted to “abolish” the EPA, believing that it “was grabbing authority and tax money to take on a fictive mission…lessening the impact of global warming.” The violent destruction of everything he held dear was not enough to change his mind.

(Emphasis added.)

And among Hochschild's subjects, Schaff isn't alone:

When asked about catastrophic oil spills that result from lax regulation, one woman says, “It’s not in the company’s own interest to have a spill or an accident…. So if there’s a spill, it’s probably the best the company could do.” Madonna Massey says: “Sure, I want clean air and water, but I trust our system to assure it.” Jackie Tabor, whom Hochschild describes as “an obedient Christian wife,” says: “You have to put up with things the way they are…. Pollution is the sacrifice we make for capitalism” ...

After repeal, the Trumpers will get inadequate insurance, or no insurance -- and they won't blame Trump, or the greedy insurance companies that won't cover them adequately. If they blame anyone, they'll blame the usual suspects: Democrats, liberals, "big government" (yes, even if the new system is far more privatized). It's what heartland whites always do. Don't expect it to change.

Crossposted at No More Mr. Nice Blog