Given this gruesome truth, one has to wonder why the Republicans are so hell-bent on getting this monstrous legislation passed. Polls show that fewer than 10 percent of Americans support the AHCA/BCRA. In a rational, democratic country, that would be the end of it. No legislation could possibly survive that kind of unpopularity. Alas, we do not live in a rational democratic country. We live in an oligarchy, increasingly controlled behind the scenes by a small wealthy elite who wield enough power to get what they want despite the will of the people. And what they want is tax cuts.
Tax cuts for the wealthy are really what the AHCA/BCRA are all about. When the Affordable Care Act (the ACA) a.k.a. Obamacare was passed, it came with tax increases to help pay for subsidies which allow less wealthy people to afford insurance. In particular, the ACA raised taxes on long term capital gains from 15 to 23.8%, and raised taxes on income above $400,000 per year from 35% to 39.6%. This new tax burden fell almost exclusively on the rich, and the rich didn't like it. So they started to write checks to Republican politicians who promised to repeal Obamacare.
And then something unexpected happened: Donald Trump won the presidency, and suddenly the Republicans actually had the power to do what they had promised to do, which meant that they had to face an inconvenient truth: Obamacare was actually a pretty good piece of legislation (and, it should be noted, it was originally a Republican idea). It could certainly be improved, but compared to what it replaced it works quite well. It's easy to forget that before Obamacare came along, if you had to buy an individual health insurance plan you were pretty much screwed. Oh, the insurance companies would happily take your money if you were healthy, but as soon as you got sick they would drop you like a hot rock. If they didn't drop you outright, they would raise your rates to the point where you could no longer afford the coverage. One way or another, getting sick in the U.S. before 2013 without access to group rates was a one-way ticket to bankruptcy. Without government mandates -- on both sides of the transaction -- individual health insurance is a scam.
So now the Republicans are in a serious bind. They promised their rich donors that they would repeal the Obamacare tax hikes, but there is no way to do that without pulling the health-care rug out from under tens of millions of ordinary Americans. That is why Mitch McConnell negotiated the BCRA in secret and tried to ram it through the Senate in less than a week: he was hoping he could get this done before anybody noticed the he is unleashing a monster.
The AHCA/BCRA is a metaphorical monster, but it is going to cause real non-metaphorical pain and suffering. It will actually kill real people. And it's going to do that so that rich people can be richer. If you're not OK with that then the next time a Republican tells you that Obamacare is a disaster, ask yourself: are they saying this because it's true, or because they have been given marching order by someone whose pockets are deeper than their sense of moral and civic duty?