× Expand Matt Northam operation Take inventory of your vital organs. Are some more vital than others?

There have been moments in the past when Republicans have actually done the right thing for disabled Americans.

Let us not forget that the elder George Bush proudly signed the Americans with Disabilities Act in 1990. Senators Bob Dole and Orrin Hatch were enthusiastic supporters of the ADA. Even George W. Bush helped make millions of extra federal dollars available for state programs supporting disabled people trying to achieve more independence by living outside of nursing homes and institutions.

So when the current batch of Republicans took over everything in November, the few aforementioned precedents provided a small shred of hope those in power might take an enlightened approach to disability issues.

But the introduction of the American Health Care Act puts that silly notion to rest once and for all. The AHCA is a brash middle finger to disabled Americans.

Let me explore just two of the many ways this bill shows contempt for disabled people. Thanks to years of hard work by disability activists, the Affordable Care Act contains a provision known as the Community First Choice Option. The CFCO provides states with millions in additional Medicaid funds if they use the money to support disabled people living in community settings. Some states have chosen this option and are putting together innovative programs. The AHCA eliminates the incentive.

And speaking of Medicaid, the AHCA absolutely destroys Medicaid as we have always known it by instituting a system of per capita limits. This means states would receive a fixed amount of Medicaid money each year and, if the needs of those receiving Medicaid exceeds the allotment, they will just have to make cuts. States could even be financially penalized for exceeding the caps.

Allotments would increase over time, but not nearly enough to keep up with inflation. Ironically, this is all being done in the name of giving states more “flexibility.” But because Medicaid is now an open-ended entitlement, where the federal financial contribution covers a percentage of a state's annual Medicaid costs regardless of the price, per capita caps give states less flexibility to get through hard economic times without hurting people who depend on Medicaid.

The AHCA also contains tax breaks that benefit the wealthiest people to the tune of hundreds of billions of dollars. Disabled people who rely on Medicaid will have to pay for these windfalls for the very rich. That’s the way it works with this batch that’s in charge right now. The poorer you are, the more of a loser you are. People with disabilities who will always rely on Medicaid are the biggest losers of all. The Republican health care bill is a proud celebration of that warped value system.

Republicans say they just want to make people take more responsibility for their own health care. So if you’re a disabled person on Medicaid and the AHCA becomes law, I suggest that you become more proactive about your health.

Start by taking inventory of your vital organs. Are some more vital than others? Are there any you can live without? Appendix? Gall bladder? Spleen? Testicles? If so, have these organs removed now, while you are still covered by Medicaid. For disabled people on Medicaid, these organs will soon be luxuries.

So the first step you can take toward better health in the Trump era is to get rid of excess body parts that might need extra health care. Then you won’t have to worry about those extra parts breaking down on you later. This will not only save taxpayers money, it will bring you great peace of mind.