Debate about "Trumpcare" — the repeal, and replacement, of the 2010 Affordable Care Act — has ignored the fact that congressional Republicans are, effectively, also working to repeal, and replace, the 1965 Medicaid Act.

This “traditional Medicaid” has covered those who are aged, blind and have disabilities for over a half-century. It serves over three-fifths of patients in nursing homes. Were the real objective to close nursing homes nationwide it could not be better achieved.

In 1965 more House Republicans voted for creating the Medicaid program than voted against it. Today the Republican House speaker, Paul Ryan, has said he first thought about cutting Medicaid while “drinking at a keg” in college. His dream is on the cusp of being realized: The House-passed American Health Care Act (AHCA) would reduce Medicaid funding by $834 billion.