As The New York Times reported on Nov. 2 about the specter of so-called tax reform, (“A Tax Plan for a New Gilded Age”), “one particularly hardhearted change would eliminate the deduction of medical expenses, which is primarily used by people with serious and chronic illnesses.”

Hardhearted indeed, a punishment aimed—per usual with the Republicans—at millions of middle- and lower-class Americans.

The nonprofit Partnership to Fight Chronic Disease reports that chronic diseases are the leading cause of death and disability in the United States, responsible for 7 out of every 10 deaths. The group estimates that 133 million Americans—about 45 percent of the population—suffer from at least one chronic disease. One of the most common is diabetes, an epidemic of such proportion that every 30 seconds a lower limb is amputated as a consequence of its terrible effects.

The Trump administration of course wants to cut Medicaid and Medicare as well as eliminating medical care tax deductions, multiplying the consequences of the chronic disease problem. It looks like Trump and the Republicans consider us lesser Americans (read: not rich) to be useless, costly, disposable.

AARP reports for 2015 that 8.8 million households—about 30 million Americans or nearly 1 out of 10 citizens—itemize medical care costs totaling $86.7 billion in expenditures (3.5 percent of total U.S. health care expenditures), reducing their tax burden by as much as $22 billion a year (0.6 percent of total annual federal tax collections). These 8.8 million households, if taxed fully on their medical expenses, would contribute as much as 15 percent of the $150 billion a year that Donald Trump and the Republican hope to transfer to the very wealthy.

Congress recently released the details of its proposed tax revisions: 65 percent of the tax savings would go to 1 percent of American households, our vaunted millionaires and billionaires who don’t need these windfalls. Huge savings would also go to multinational corporations whom The New York Times reports are hiding $200-$300 billion in profits every year offshore to avoid U.S. taxes.

Why am I concerned, other than because this is incredibly unfair? Because it’s personal. My wife has Parkinson’s and dementia. It currently costs more than $90,000 a year out-of-pocket to keep her safe, about double our Social Security income. The rest comes from our limited savings. There are millions of elderly households like mine with the same problem. What do we do when we run out of money and when our family—our sons and daughters—cannot afford to help? Many of these households will go broke and live subsistence lives. Perhaps they will be killed by Trump’s tax reform.

Caring for someone with Parkinson’s and dementia is a full-time job, 24/7, 8,760 hours a year, unpaid. There is no let-up. You are forced to do everything for your partner even when you have other caregivers in attendance. This is your life “until death do us part.” People who have never suffered a life-ending disability of a loved one have no idea how hard this is. To impose additional costs on those who suffer like this, to impose those costs so as to the enrich the already rich, reveals the character of the people behind such proposals: They are vicious, cruel, violent, without empathy, without compassion. In short, Trumpian.

Little has been reported on the consequences of eliminating the medical care tax deduction and what has been reported has been tossed-off, a kind of brushing aside, suggesting it is inconsequential.

As to the headline on this article: I would never kill my wife. But should she live long enough, and I continue to provide the care that I do, the care that she deserves, and should she die before I do, I may be left destitute. I am sure people in my situation know precisely what I am facing. Perhaps people in my shoes will luck out, and Congress will come to its senses. I am not holding my breath.