Krugman nails it:
Believe it or not, conservatives actually do have a more or less coherent vision of health care. It’s basically pure Ayn Rand: if you’re sick or poor, you’re on your own, and those who are more fortunate have no obligation to help. In fact, it’s immoral to demand that they help.
This is a coherent doctrine; it’s what conservative health care “experts” say when they aren’t running for public office, or closely connected to anyone who is. I think it’s a terrible doctrine – both cruel and wrong in practice, because buying health care isn’t and can’t be like buying furniture. Still, if Republicans had run on this platform and won, we’d have to admit that the public agrees.
But think of how Republicans have actually run against Obamacare. They’ve lambasted the law for not covering everyone, even though their fundamental philosophy is NOT to cover everyone, or accept any responsibility for the uninsured. They’ve denied that their massive cuts to Medicaid are actually cuts, pretending to care about the people they not-so-privately consider moochers.
The trouble they’re having therefore has nothing to do with tactics, or for that matter with Trump. It’s what happens when many years of complete fraudulence come up against reality.
This is the same adolescent fantasy drove Eddie Lampert to destroy Sears.