As previously reported, Medicaid cuts in the form of per capita caps will disproportionately affect people with disabilities, and this problem remains unchanged from the House version of the bill. It would also allow states to enforce work requirements for Medicaid recipients who are not disabled or pregnant. That’s red meat for conservatives, but it assumes that poor people are somehow allergic to work, and there is no evidence that is true. America’s recovery from the recession has been uneven: Some communities still face high unemployment rates not because their residents are lazy but because there is simply not enough work. The Senate bill would penalize those communities for an economic crisis they did not create. That doesn’t matter to Republicans. This bill, if passed, benefits the party’s wealthy donors, and that is a deliberate choice. “Personal responsibility,” “common sense,” “small government”—this is scaffolding, erected to obscure a crumbling edifice. The Republican Party is committed to the maintenance of a grossly unequal social hierarchy that handicaps the poor for the circumstances of their lives. This bill is the starkest manifestation of that political project. And though there may be some opposition to this bill from within Republican ranks, it will not be opposition to the substance of the party’s worldview but rather to the details of its implementation.