GOPers, especially those of the Ryan ilk, believe in the "free market" to the point of fanaticism. It's like a religion to them. They believe that every aspect of society should be subject to the "free market," and they believe this as absolutely as Christians believe in the Resurrection. The Resurrection can't be proved scientifically, but Christians believe it anyhow, as an article of faith. In fact, the fact that it can't be explained and that it happened only that one time sort of proves its miraculous nature, which in a rather circular manner supports that faith.
Likewise, Ryanites believe in the unprovable miracle of the free market. But while the Resurrection can't be proved, it hasn't ever actually been disproved either (although its extreme unlikelihood, given the basic rules of biology and physics, is certainly demonstrable). The claimed absolute perfection of free-market economics, in contrast, has been regularly disproved. Reagan's "trickle-down" economics doesn't work. We've seen proof of that over and over. For one thing, there's no such thing as a free market; the marketplace has rules that even Ryanites accept, such as the court system. Most federal litigation involves businesses vs. businesses in which a party is seeking, for example, to enforce or avoid a contract or protect intellectual property. The free market has its own acknowledged rules, so it's not really "free."
And some things can't be managed by a free market at all. No sane insurance executive would go into the business of insuring sick old people because it would be too expensive to provide coverage, and therefore nobody could afford to pay the premiums. This is precisely why we have Medicare. The alternative of just letting people go broke and/or die was, at least for some, completely unacceptable, but because this group of people is effectively uninsurable in a free insurance market, the government stepped in. The ACA was an attempt to remain within a free-ish market system (because it was politically impossible to get a far-superior single-payer system past the GOP) but still make insurance affordable for most people, using government subsidies.
There is simply no way for Ryan's free market to make affordable health insurance available to everyone who needs it. Insurance, by its very nature, is pure socialism: Everybody pays into a pool for the future possible needs of everyone, but some people will never need the benefits while others will. It is this very un-free-market nature of universal coverage that the Ryanites hate because it contradicts their deeply held religious belief in the free market that doesn't exist. The cruel results of this rigid belief as applied to health insurance is unimportant because, like so many religions, adherence to the core belief is more important than anything else.
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