"Let them eat cake"

Maria Antoinette famously declared that poor French citizens without bread had an alternative. Utah Republican Jason Chaffetz has a modern-day version of the comment that ultimately cost the last queen of France her head.

Americans have choices. And they've got to make a choice. And so, maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest it in their own health care. They've got to make those decisions for themselves.”

Chaffetz, former chair of the House Oversight Committee that spent millions of taxpayer dollars in multiple investigations trying to assess blame for Benghazi and Hillary Clinton's emails, may not lose his head -- or even his seat in Congress -- for comparing the cost of an $800 iPhone with an estimated $4,716 annual health care premium.

But his callous comparison (which he later tried to walk back) will likely stand as the catch phrase for opponents of the American Health Care Act, aka the Unaffordable Care Act.

Initial response to the GOP plan to repeal Obamacare, seven years in the making, has been harsh, draw critics on both the left and right. While the proposal basically eliminates taxes (on the rich) and subsidies (for the poor) and shifts benefits to healthy and higher-income Americans, many conservatives lament the bill is "Obamacare Lite" and therefore unacceptable.

That's certainly an interesting focus since it appears the main provisions retained from the Affordable Care Act are the highly popular end to pre-existing condition limits and allowing children to remain on their parents plan until age 26.

The unhappiness is likely centered on the obviously political move to maintain Medicaid funding at current levels until 2020 -- after the next presidential election.

... maybe rather than getting that new iPhone that they just love and they want to go spend hundreds of dollars on that, maybe they should invest it in their own health care.

But there is plenty of concern for supporters of universal health care (as opposed to universal access, if you can afford it). And in Massachusetts a lot of that attention is also focused on Medicaid, which has become a major foundation for what has been called Romneycare.

While MassHealth, as Medicaid is known here, is growing at what Gov. Charlie Baker and some legislative leaders fear is unsustainable levels, the federal infusion of dollars has allowed the state to reach near universal coverage while also working to find new models to bring down the cost of providing that care.

The $56 billion Medicaid waiver signed in the final months of the Obama administration could be in jeopardy as "repeal and replace" moves forward.

Combine that with separate efforts to rein in costs by regulating hospital prices and Massachusetts' nation-leading efforts to cope with health care access and spending could be jeopardized.

It's very early in the process: there aren't even estimates of what the Ryan proposal will do to meet President Trump's campaign pledge to create a health care law that provides better care at lower costs.

But based on the initial reaction from both sides of the political divide, it's highly unlikely this version will do anything other reduce care and raise prices. Especially after the 2020 election.