Paul Ryan is an Ayn Rand acolyte. If there's one thing which Rand had the utmost contempt for, it was altruism. It's survival of the fittest, baby! The only form of "Christianity" that can be reconciled to Rand's message is that heresy, the "prosperity gospel". Those who are wealthy prove by their very wealth that they are favored by God, and those who are poor must have done something to warrant their poverty.

Medicare and Social Security both would be on perfectly solid ground forever if the government just raised the upper limit on income taxes to pay for it, instead of letting the task fall solely on the shoulders of the middle class. And it would be taxing people who could very well afford it. But we mustn't have that! That would be inconveniencing those who have received God's favor! Altruism is for suckers and lovers of weakness, thus saith the Randians.

Most of Trump's followers didn't vote for this. They're the ones carrying signs saying, Keep government out of my Medicare!