After the Republican Party’s seven-year attempt to dismantle the Affordable Care Act kicked the bucket this week, Donald Trump declared that he would “let Obamacare fail.” He has plenty of options for moving that failure along and his actions inevitably would hit poor people the hardest, a fact that does not surprise Jack Frech who spent 30 years serving the poor in Appalachian Ohio. Frech was saddened but not surprised by the proposals put forward by house and Senate Republicans. He says such ideas are both perennial and bipartisan. For example the Clinton administration bundled what was once federal welfare assistance into block grants to states where the money often is misdirected or hoarded by the states, even as its shriveled by inflation. For context in the ensuing healthcare battles we are replaying a conversation Brooke had with Jack just after the house bill was passed.