For millions of Americans, President-elect Donald Trump’s selection of U.S. Rep. Tom Price, R-Georgia, as Secretary of Health and Human Services represents the worst kind of news: A completely uncertain and volatile medical future.

Price, an orthopedic surgeon from the suburbs of Atlanta, has been a leading opponent of President Barack Obama’s signature Affordable Care Act, peddling his replacement proposal – the Empowering Patients First Act – in recent budgets.

And what is the Empowering Patients First Act? A hodgepodge of warmed-over Republican “free market” leftovers that will hurt millions of people in the interest of insurance companies’ bottom lines. This includes voucherizing Medicare, block-granting Medicaid and installing high-deductible Healthcare Savings Accounts as the beau ideal for the individual market.

In short, they will rip away health insurance from millions of people by creating a system that prices individuals out of good, affordable insurance and cuts benefits for the old and the poor.

On, the incoming Trump government marches: The pain is on its way, its way, hoorah hoorah

Price and House Speaker Paul Ryan unveiled their replacement plan back in June, and it’s a doozy.

They will reestablish “mini-med” insurance plans that provide people token coverage and leave them bankrupt in the case of medical catastrophe. But hey, there will still be government subsidies via tax credits to purchase these awful plans.

They will expand the use of high-deductible HSAs, which will “help patients understand the true cost of care,” according to the plan. How will patients better “understand the true cost of care”? By going broke from the high deductibles.

They will once again allow insurance companies to charge young people less while price gouging old people, because, well, fk Granny and Granddad, I guess.

And they will attempt to deal with the pre-existing conditions/individual mandate paradox (Without the mandates, many healthy Americans won’t purchase insurance, which means the insurance companies will either deny coverage to sick people or hike premiums to unaffordable levels) by creating statewide “high risk pools” for the sickest people.

These high risk pools have been tried before, and failed, because (SHOCKER) they went underfunded and were unaffordable. I suppose people with sever sickness will just have to trust Republicans to care about adequately funding government programs… trust them with their lives.

And finally, the coup d’grace: Medicaid funds would go directly to the states either as block grants or as per-capita allotments. And Medicare? Medicare would move toward a “premium support” model where seniors would choose a private health plan, and Medicare pays part of the premium. But not all, because, again, fk Granny and Granddad and their high-cost health problems.

Now, as the battle over these noxious plans ensues, we’re going to hear a lot of gum-flapping from the Republicans about how they don’t really want to take health insurance away from millions of people, they just want to fix the problems that Obamacare created.

But remember this: Their plan literally budgets for taking health insurance away from millions of people.

If you’ll recall, before the ACA, millions of people without health insurance relied on visiting the emergency room in cases of medical catastrophe. The government refunded healthcare providers through what’s known as “disproportionate share hospital” payments for these uninsured people.

After the ACA was passed, these DSH payments were cut because it was expected millions of people would get insurance and the government wouldn’t have to spend so much on this. In fact, they were set to be phased out entirely.

Under Dr. Price’s plan, those cuts are repealed and, come 2021, DSH would be replaced with “one combined national pool of uncompensated care (UCC) funds.” Why? Because millions of people are going to lose their health insurance and once again become reliant on emergency rooms for their medical needs, and the Republicans want a centralized slush fund to help control the costs of that.

Yes indeed, the pain is on its way.

As I was writing this, I received an email from my fellow Ohioan, U.S. Rep. Tim Ryan, who is challenging House Minority Leader Nancy Pelosi for her leadership position. If he wins that position, he’ll be charged with leading the opposition to this terrible plan.

In the release, Ryan said that Price “has dedicated himself to repealing reforms that gave 20 million Americans access to health insurance and disallowed insurance companies from discriminating against citizens with pre-existing conditions.”

“Further, while millions of seniors depend on Medicare, Dr. Price continues his campaign to end the Medicare guarantee by turning it into a voucher program,” Ryan said. “If Dr. Price is going to defend the health and wellbeing of America’s citizens, he needs to abandon these destructive policies and, instead, work with Democrats to protect Medicare; lower prescription drug costs; ensure every citizen access to affordable health insurance; and defend a women’s right to make her own health decisions—without incurring unreasonable costs or hurdles.”

D.C. DeWitt is a writer and man of sport and leisure. He has also written for Government Executive’s, the National Journal’s The Hotline, and The New York Observer’s He is the Associate Editor of The Athens NEWS in Athens, Ohio. DeWitt can be found on Facebook and Twitter @DC_DeWitt.