It turns out that the American Health Care Act is far more repeal than replace. Republicans are supplanting a health care law with a budget and tax cutting measure. Millions will lose access to insurance in the process.

In terms of people having access to health insurance coverage, and so health care, the Republican plan would essentially return the nation to pre-Affordable Care Act days, a Congressional Budget Office evaluation has concluded.

Before the passage of ACA, 57 million Americans, about 18.5 percent of the population, did not have access to health insurance. That number has dropped to 28 million, about 8.5 percent of Americans. By 2026, if the AHCA becomes law, 52 million Americans will not have health insurance, the CBO estimates, 15 percent of the projected population.

The damage will be quick. If the law wins approval this spring, by next year 14 million fewer people will have health insurance.

The reasons are no surprise.

Gone would be the mandate that individuals must buy health insurance or face penalties at tax time. This measure encourages younger, healthier people to buy insurance rather than wait until they face a health crisis. With more people contributing, insurance companies can hold down premiums.

In the short term, at least, premiums would increase under the GOP proposal, the CBO concluded, further driving up the ranks of the uninsured. In time, as older and sicker folk go without health insurance, premiums would go down for those lucky enough to have it.

The expansion of Medicaid under the ACA to provide health insurance to the near poor would end and be reversed, leaving yet more people without access to health care, except for perhaps your occasional free clinic.

On the other hand, the AHCA would cut taxes $900 billion and spending $1.2 trillion over the next decade, per the CBO analysis. Over that same period the legislation would reduce federal deficits by $337 billion.

Those calculations do not factor in the damage done to the economy when millions, without access to health care, see their credit and buying power destroyed by medical bills they cannot pay. There is also no number attached to human suffering, physical and emotional, by not having access to health care.

Yet the bill lines up with the long-held priorities of House Speaker Paul Ryan, R-Wisconsin, who has a slavish belief in free markets and found abhorrent the policy that the federal government could mandate the purchase of a product. Ryan has a made a political career of fighting against deficit spending.

On the other hand, President Trump’s endorsement of the bill exposes him as a liar and a fraud.

In an interview with The Washington Post just a few days before his inauguration, Trump repeated a claim he had made throughout the campaign.

“We’re going to have insurance for everybody. There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us,” said Trump, adding that insurance would be “much less expensive and much better.”

This bill is in complete contradiction to that statement. By reducing access to Medicaid and eliminating the subsidies that have helped individuals buy health insurance through the exchanges, millions won’t be able to pay for it and they won’t get it.

Instead, this law would strip access to health care from the same struggling working-class Americans who supported Trump because he said he would fight to make their lives better. It would benefit the well-off by cutting taxes now used to provide health insurance subsidies.

Another presidential candidate who ran on a populist agenda, summed it up well.

“Throwing 24 million Americans off of health insurance, raising premiums for older, low-income Americans, while giving $285 billion in tax breaks to the top 2 percent is a disgusting and immoral proposal. Thousands of Americans will die if this legislation is passed,” said Sen. Bernie Sanders, a Vermont Democrat.

Unlike Trump, Sanders had a plan -- extend the Medicare program to cover all Americans.

All Trump had was hollow promises and sound bites. He never had a plan to “take care of everybody,” as he promised in a "60 Minutes" interview. Instead Trump left the bill drafting to fiscal conservatives such as Ryan. They placed a higher priority on budget and tax cutting than on making sure Americans have someplace to turn when they get sick.