The American Health Care Act has managed to become the least popular aspect of the Trump government despite the fact that the ethical and legal scandals surrounding the president himself have largely obscured something remarkable: The central justification for the Republican health care bill is a lie.

Every legislative initiative is presented to the public as an attempt to solve some genuine problem or advance some credible moral cause. The Affordable Care Act, aka Obamacare, was devised to address problems like widespread uninsurance, medical bankruptcy, the failure of the individual insurance market, and unsustainable growth of health care costs. The many bills that have been drafted over the years to price greenhouse gas emissions were meant to reduce the unacceptable risk of runaway climate change. The first Bush tax cuts were initially presented as a means of returning budget surpluses to taxpayers, then as a means of fending off a recession. Neither rationale honestly conveyed why Republicans sought permanent, regressive tax cuts, but at least the budget surpluses and the recession actually existed.

The AHCA, according to House Speaker Paul Ryan, is a “rescue mission” to save Affordable Care Act beneficiaries from the system’s inevitable collapse. That premise is so commonly held on the right—and so commonly repeated as though it were incontrovertible—that it’s seldom challenged by the press. It forms the strategic basis not just of plans to repeal the ACA, but of plans to leave it in place for now.

With today's news, the 'Collapse and Replace' of Obamacare may prove to be the most effective path forward. — Lindsey Graham (@LindseyGrahamSC) May 24, 2017

It is also completely false. The main public justification for the Republican Party’s top legislative priority isn’t some fact-based pretext, like the justifications for the Bush tax cuts, but a complete fabrication.



This is not to say that many ACA marketplaces don’t have challenges, some of them serious. But the AHCA isn’t what anyone credible would formulate as a solution to those problems. If Republicans intended their health care bill to be a “rescue mission” for those who live in markets with zero or one insurers, it would be a targeted bill, rather than one that would disrupt and perhaps destroy ACA marketplaces that are functioning well.