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Apparently we are going to have to endure a 2020 presidential campaign in which Donald Trump, yet again, promises that Republicans will pass the awesomest health care plan the world has ever seen—just as soon as they’re returned to power. Back in the real world, here’s what’s actually happening:

There used to be a lot of health insurance horror stories like Charley Butler’s. After the Montana truck driver was diagnosed with testicular cancer in 2016, his insurer balked at paying tens of thousands of dollars in medical bills and then moved to cancel his coverage over a preexisting medical condition. These practices were largely banned by the Affordable Care Act, or Obamacare, which set new national health insurance standards to protect consumers and bar discrimination based on preexisting conditions. But as the Trump administration has pushed to relax many of these rules, skimpier short-term health plans like the one Butler bought are roaring back, threatening to subject consumers to many of the ordeals patients endured before the healthcare law.

Short-term health plans, a creature given new life recently by Republicans, are basically a scam:

In many cases, consumers don’t even think to ask if plans cover preexisting medical conditions, said Dania Palanker of the Georgetown University Center on Health Insurance Reforms. “We are at a point now where people assume that all health insurance covers preexisting conditions,” Palanker said. “In the same way, you wouldn’t think to ask if a new car you are buying has seat belts.”

Thanks to Obamacare, everyone just assumes that every health plan covers preexisting conditions. Republicans, of course, all swear on their mothers’ graves that they, too, want every plan to cover preexisting conditions. They’re practically insulted if anyone suggests otherwise. And yet, they’re hellbent on killing Obamacare. Short of that, they’re hellbent on undermining it, ensuring that crappy, short-term health plans don’t have to cover things like preexisting conditions. What a bunch of assholes.