Donald Trump was in Nevada over the weekend, campaigning in support of Sen. Dean Heller (R), and reflected on the vote Sen. John McCain (R-Ariz.) cast against the Republicans’ plan to repeal the Affordable Care Act. The president told supporters:

“It’s all right, because we’ve essentially gutted it anyway.”

Seven seconds later, Trump added:

“Just remember, if you see [premiums going up], it is the Democrats’ fault.”

The president’s supporters cheered with approval, seemingly oblivious to the rhetorical whiplash. Trump is absolutely certain that, in his words, he’s “essentially gutted” the backbone of his own country’s health care system, and he’s equally certain that the consequences of his actions should be blamed on the one group of people who have no control over the levers of federal power.

There’s no reason for any sensible person to take this seriously, but it is worth understanding why Trump seems a little defensive on the issue.

Two big insurers in Texas requested significant premium increases last week, and both said the price hikes were the direct result of Republican policies. As we discussed a few weeks ago, Texas is hardly alone: insurers in states across the country have been submitting rate hikes to regulators, and they’re all saying the same thing: Republican changes to the Affordable Care Act, spearheaded by Donald Trump, have undermined the American market to the detriment of consumers.

Reporting on the latest data from the Congressional Budget Office, Axios recently added, “Insurance premiums tend to go up every year, but the magnitude of these increases stems largely from the repeal of the ACA’s individual mandate, the expansion of skimpy short-term plans, and the decision last year to cut off the law’s cost-sharing payments.”

When the president took these actions, quite a few of us said his moves would make things worse. The bill is now due – though it’s not Trump who’ll pay more, it’s the consumers he chose to punish out of political spite.

Even former Health and Human Services Secretary Tom Price, a former far-right congressman from Trump’s own cabinet, recently conceded that his party’s efforts “drive up the costs” for many consumers.

Whether the president realizes this or not, lying to those same consumers, telling them to blame Democrats for his actions, only makes this worse.

It’s not exactly a secret that Trump has struggled to understand the basics of the health care debate, but on Saturday in Nevada, the president very nearly packaged things in a way even he could understand: the White House “essentially gutted” the system, and as a result, Americans are now paying more.

If Trump has a coherent explanation as to why this is Democrats’ fault, I’m eager to hear it.