Donald Trump has won the White House and now, Republicans have control of the Senate and Congress, too. House Speaker Paul Ryan has hinted at plans to privatize Medicare. Ryan s Ayn Randish vision for America has been well documented with his plans to slash the safety net while giving a big middle finger to the middle and lower-income classes.Yes, this is a war. One in which Americans will suffer greatly. Millions of low-income Americans on Medicaid could lose their health coverage if Trump and the Republican-controlled Congress follow through with their plans.Vox reports that Trump has: already endorsed Ryan s plans on Medicaid and has attacked food stamps at length. His vice president, Mike Pence, is a longtime friend and congressional ally of Ryan s who if anything has argued for larger cuts than the ones Ryan wants.We can expect an increase in poverty. I ve been working on these issues since 1972,  Robert Greenstein, the founder and president of the Center on Budget and Policy Priorities and Washington s leading advocate for poor and low-income Americans, said, according to Vox.  This is by far the gravest threat to the safety net, and to low-income people, that I ve seen in my close to half a century of working on these issues. I think there s a potential in the first seven months, by the August recess, for Congress to pass policies that do more to increase poverty and hardship and widen inequality than we ve seen in half a century. If Obamacare is repealed without a viable replacement, 22 million people will be denied coverage.Paul Ryan, like his conservative colleagues, seeks fewer regulations for insurance companies. Insurance companies would offer worse policies and the quality of care would go down.Trump s replacement plan is even worse than Ryan s.The Committee for a Responsible Federal Budget estimates it d spare just 1 million people who d otherwise lose insurance through Obamacare repeal. Full repeal without replacement takes insurance away from 22 million; Trump s plan takes it away from 21 million. The difference is minimal.And yet, here s the thing. Trump has already broken numerous campaign promises and he s not even in office yet. He has suggested that he won t fully repeal Obamacare but now, he s beholden to Republicans who control the Senate and the House. Even if he says no, the wheels are in motion. He s the one who started turning them.Because eating while poor is bad:CBPP estimates that the most recent House budget gets 62 percent of its cuts from programs for low- and moderate-income people. That includes at least $150 billion in cuts to food stamps and nearly $500 billion in mostly unspecified cuts to other low-income programs like SSI (which provides cash to the disabled and elderly), Pell Grants, and what little remains of welfare.Republicans have been trying to eradicate President Obama s signature healthcare legislation so it was watered down. Tea Party Republicans went to town halls where Democrats attempted to answer questions from constituents. The noise from Republicans was deafening and hardly a word could be heard about the bill. So, it got watered down because conservatives told us that socialism is bad. They told us this after driving to the town hall meetings on taxpayer funded public roads.As it happens, medical professionals do not want Obamacare repealed. Trump and his Republican colleagues just want you to think that.Featured image via Zach Gibson/Getty Images