People who voted for Donald Trump and receive Medicaid are about to get some really bad news.For decades, Republicans have wanted to destroy Medicaid, a healthcare program that helps low income people with a combination of federal and state resources.The idea of block grants would mostly achieve this goal by slashing the amount of money the federal government provides and would shift the fiscal responsibility to the states.According to the New York Times,A block grant would be a radical change. Since its creation in 1965, Medicaid has been an open-ended entitlement. If more people become eligible because of a recession, or if costs go up because of the use of expensive new medicines, states receive more federal money.If Congress decides to create block grants for Medicaid, lawmakers will face thorny questions with huge political and financial implications: How much money will each state receive? How will the initial allotments be adjusted   for population changes, for general inflation, for increases in medical prices, for the discovery of new drugs and treatments? Will the federal government require states to cover certain populations and services? Will states receive extra money if they have not expanded Medicaid eligibility under the Affordable Care Act, but decide to do so in the future?Also, Republicans could punish blue states by giving them less money while giving more money to red states.But once the money runs out, people will suffer regardless of which state they live in because that s what a block grant is. It s a set amount of money. States would have to decide if they want to spend more money on healthcare after the funding dries up. Basically, lawmakers will be deciding if you get medical care or not. In other words, death panels.Massachusetts Governor Charlie Baker told Republicans in Congress that,  States would most likely make decisions based mainly on fiscal reasons rather than the health care needs of vulnerable populations. Louisiana Governor John Bel Edwards echoed the same concerns. Under such a scenario, flexibility would really mean flexibility to cut critical services for our most vulnerable populations, including poor children, people with disabilities and seniors in need of nursing home and home-based care,  he said.Again, this is basically the death panels Sarah Palin was freaking out about when the Affordable Care Act passed, only these are real and would be run by the states because the federal government is forcing them to decide who gets care and who doesn t by imposing funding limits.Medicaid covers more than 70 million Americans across the country, many of whom are conservatives in some of the poorest states. That s 70 million people who are going to face great suffering and death over the next four years if Trump and Republicans have their way.Featured Image: Spencer Platt/Getty Images