Donald Trump lies. Extravagantly. Obviously. Constantly. He is especially prone to lying about public policy issues where he is on the wrong side of public opinion (or, if you want to split hairs, he has a habit of saying untrue things that he may or may not personally understand to be false, and that he often appears to make up from whole cloth). And now that we are approaching the final days of the midterm races, his flights of fabulism seem to be reaching bizarre new altitudes. For instance:

Republicans will totally protect people with Pre-Existing Conditions, Democrats will not! Vote Republican. — Donald J. Trump (@realDonaldTrump) October 24, 2018

This is the sort of night is day, black is white, opposite-day variety of lie that Trump sometimes resorts to when he is desperate or frustrated—the health care equivalent of when he stood on stage with Hillary Clinton and insisted, “I’m not the puppet! You’re the puppet!” Republicans spent much of 2017 attempting to repeal the Affordable Care Act, which bans insurers from discriminating against patients with pre-existing conditions. Democrats fought to protect it. Meanwhile, the White House has backed a federal lawsuit in Texas that seeks to strike down all of Obamacare, including its pre-existing condition rules, as unconstitutional. To say Democrats “will not” protect Americans with pre-existing conditions, while Republicans “totally” will is a simply surreal and childlike argument.

Of course, the GOP has tried to muddy the waters on this issue many times before. Obamacare’s rules on pre-existing conditions are its most popular feature. When Republicans tried to repeal the health care law in 2017, they often argued, unconvincingly, that their various replacement proposals would continue protecting the sick. The midterm campaign has delivered a farcical repeat of this dynamic. Democrats have hammered on the pre-existing conditions issue. Backed into a corner, Republican candidates like Wisconsin Gov. Scott Walker and Missouri Attorney General Josh Hawley—who is running for Senate—have released ads claiming that they support the protections—even though they signed on to the Texas lawsuit.

Despite the GOP’s attempts at smoke blowing, voters seem to understand the basic dynamics of it. According to a recent poll by the Kaiser Family Foundation, 58 percent of Americans believe Democrats will do a better job protecting patients with pre-existing conditions; only 26 percent trust Republicans more. Trump’s instinct for overcoming this problem is apparently to lie even more flagrantly. But unlike his made-up plan for a middle-income tax cut, which some Republicans are at least playing along with, Trump can’t will this fantasy into reality—Democrats aren’t suddenly going to turn against Obamacare, after all. And it seems unlikely to persuade many voters, given that public attitudes on this issue appear reasonably set.

Because everything Trump does comes garnished with a grotesque twist of irony, the president is pushing all of this out at precisely the moment his own administration is undercutting the pre-existing conditions protections that already exist, and that he previously tried to dismantle through his failed Obamacare repeal efforts. This week, the Centers for Medicare and Medicaid Services issued a new rule that would give states the option to let residents use their Obamacare premium subsidies to buy skimpy, “limited duration” health plans. These policies don’t need to cover all the same benefits mandated under Obamacare coverage, and the companies that sell them can reject customers based on their health. They appeal mostly to the young and healthy. And the more people who choose to buy them rather than comprehensive plans, the more expensive coverage available to people with pre-existing conditions on Obamacare’s exchanges will become. If there’s any upside to Trump’s clumsy lying, it’s that it might lead a few more voters to read about what his administration is actually up to.