Paul Ryan approves of Kevin McCarthy's ability to lie.

Boy-howdy the fact checkers are earning their pay after Thursday's Trumpcare vote, as they figure out what the bill actually does versus what Republicans say it does. Note that those two things have yet to coincide. Because, according to Republicans, no one at all will ever lose their health insurance no matter what. Here's the Washington Post's Glenn Kessler take on House Majority Leader Kevin McCarthy's assertion that "We're not taking a benefit away. Nobody on Medicaid is going to be taken away."

Set aside the unfortunate phrasing (or maybe Republicans were actually considering disappearing Medicaid recipients?), that's just flat-out bullshit, or in Kessler's terms, three Pinocchios.

Matt Sparks, a spokesman for McCarthy, offered this explanation: “There are no changes until 2020. Then states will continue to receive the enhanced federal match for current enrollees.” McCarthy’s claim hinges on the phrase “current enrollees.” The Congressional Budget Office, in its evaluation of the first version of the AHCA, said the reduction in funding would result in 14 million fewer Medicaid enrollees by 2026, a decline of about 17 percent compared with current law. Much of the decline would stem from the proposal’s termination of the enhanced federal match for new enrollees in states that choose to expand Medicaid, as well as a new per-person cap on federal payments to states. A new, lower federal match rate would apply to new enrollees after Dec. 31, 2019. […] In any case, current enrollees are grandfathered in, right? Well, the problem is that people cycle in and out of Medicaid all the time, as they change or lose jobs. The CBO concluded that the reduction in spending would increase quickly as the grandfathered enrollees cycle off the program and are replaced by new enrollees. Indeed, historical data cited by the CBO indicated that fewer than one-third of those enrolled as of Dec. 31, 2019, "would have maintained continuous eligibility two years later."

In other words, McCarthy is saying that the exact same people on Medicaid now will continue to be on Medicaid for the next three years. Life, and Medicaid, doesn't work that way. Medicaid has a lot of what the health wonks call "churn," as does the insurance industry as a whole. People's life circumstances are always changing—jobs, locations, marital status, health status. All that means is where and how they get their insurance changes and that's true of the Medicaid expansion population, too. That's one of those complicated health care things, though, that you can't expect Republican lawmakers to grasp when they're making policy.

Kessler was generous in just giving McCarthy four Pinocchios out of five. I'd have called him a lying sack of shit dumbass, which would warrant at least five.