The republicans, in particular Ryan, has never made any secret that one of their goals was to gut Medicaid.  It's part of their effort to eliminate all that came from the New Deal.  Reagan began the action to gut worker rights and kill worker Unions.   No one should be surprised by this.  They do not believe in America and they certainly do not support American's unless they are filthy rich.  It is all part of their belief system that only they (the rich republicans) are graced by their god.