Surgeon, New Yorker writer, and top health care wonk Atul Gawande unleashed a devastating critique of the American Health Care Act as House Republicans are poised to pass it.

The bill would replace Obamacare with a plan that would cut taxes for the wealthy and endanger health care coverage for millions. Gawande expressed baffled rage against the bill in a tweetstorm on Thursday.

Gawande’s assessment isn’t so different from other health care experts, who say that the version of the AHCA that the House is voting on Thursday hasn’t fixed the problems with the version they nearly voted on (but pulled back at the last minute) in March — and has added new problems of its own.

This isn’t a wonk in fact-checking mode. It’s a person who cares about the health care system trying to wrap his head around a huge cognitive dissonance. Many Republicans in Congress claim they want to replace Obamacare with something that will get Americans cheaper, better health insurance. Gawande grimly observes, in his interpretation of the available information from the Congressional Budget Office, that the bill could increase early death for many Americans.

It’s a “travesty.” It’s not a “sane solution.” It is not something about which Gawande feels inclined to be polite.

The original GOP bill, which was withdrawn on March 24, would have: 1. Cut spending on health care programs by $1.2 trillion dollars. — Atul Gawande (@Atul_Gawande) May 4, 2017

3. Replaced individual mandate with 30% premium surcharge if you have a 63 day gap in coverage. — Atul Gawande (@Atul_Gawande) May 4, 2017

5. Allowed insurers to charge older people up to 5X more than younger people. — Atul Gawande (@Atul_Gawande) May 4, 2017

7. But at least still maintained pre-ex protections and minimum benefit standards (maternity, mental health). — Atul Gawande (@Atul_Gawande) May 4, 2017

… it would massively increase deductibles and other costs for lower income people who do get insurance;… — Atul Gawande (@Atul_Gawande) May 4, 2017

So now the amended bill would still do all that but also let states opt out of pre-ex protections and basic benefit standards. — Atul Gawande (@Atul_Gawande) May 4, 2017