So what’s this all about? One reason, the sociologist Daniel Little suggested in a recent essay, is market ideology: If the market is always right, then people who end up poor must deserve to be poor. I’d add that some leading Republicans are, in their minds, acting out adolescent libertarian fantasies. “It’s as if we’re living in an Ayn Rand novel right now,” declared Paul Ryan in 2009.
And what "this" is all about is the Republican war on the poor, which of course would be inspired by that eccentric hack novelist who got her first big break in life from the Bolsheviks.
As Krugman says:
All of this hostility to the poor has culminated in the truly astonishing refusal of many states to participate in the Medicaid expansion. Bear in mind that the federal government would pay for this expansion, and that the money thus spent would benefit hospitals and the local economy as well as the direct recipients. But a majority of Republican-controlled state governments are, it turns out, willing to pay a large economic and fiscal price in order to ensure that aid doesn’t reach the poor.
Astonishing only if you weren't already aware of what a bunch of evil freaks Republicans are.