About 25 percent of people in households with annual incomes below $25,000 are uninsured, compared with just 8 percent in households earning more than $75,000. Do the working poor not deserve to have their chronic medical conditions treated as punishment for not making enough money?

Other rich countries provide truly universal care through single-payer systems of various kinds. Obama chose instead to model the Affordable Care Act after a program implemented on the state level by the Republican governor who became Obama’s opponent in the 2012 presidential election. Yes, before Obamacare there was Romneycare, a private-sector, free-market solution designed to be in accord with the GOP’s most hallowed principles.

But in the years between Mitt Romney’s tenure in Massachusetts and his presidential run, the Republican Party lost its way, or perhaps its mind.

The party shows no serious interest in finding a GOP-friendly way to provide the uninsured with access to health care. Rather, it pursues two goals at any cost: opposing Obama no matter what he does, and making people see Obamacare as a failure.

For the radical far right, making health care more widely available through the existing network of insurers, most of them for-profit companies, is a giant leap toward godless socialism. These extremists hold outsize power in the GOP — enough to make sane Republican officials fear, with some reason, that anything short of massive resistance to Obamacare could lead to a primary challenge and a shortened career.

Some of Obamacare’s provisions are already in force and seem to be having the intended effect. For example, young adults are now allowed to stay on their parents’ health insurancepolicies until age 26. In 2009, 29.8 percent of those 19 through 25 were uninsured; in 2012, 27.2 percent lacked insurance, a modest but significant decline.

Now the central provisions of the Affordable Care Act are set to come into effect — the individual mandate, the insurance exchanges, the guarantee of coverage for those with preexisting conditions. Republicans scream that Obamacare is sure to fail. But what they really fear is that it will succeed.

That’s the reason for all the desperation. Republicans are afraid that Obamacare will not prove to be a bureaucratic nightmare — that Americans, in fact, will find they actually like it. The GOP fears that Obamacare will even be credited with slowing the rise of health-care costs to a more manageable rate. There are signs, in fact, that this “bending of the curve” is already taking place: Medical costs are still rising much faster than inflation but at the slowest rate in decades.

Keeping premiums under control will require persuading lots of young, healthy people to buy insurance — and thus, in effect, subsidize those who are older and sicker. That is why a group called Generation Opportunity, funded by the ultraconservative Koch brothers, plans to tour college campuses with disgusting ads in which a creepy Uncle Sam subjects a young woman to a pelvic examination.

The GOP message: Whatever you do, don’t buy health insurance. It may be — shudder — good for you.”

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