"The problem with Obamacare—the actuary is called a ‘death spiral,'" he said. "It’s a really kind of ugly, gruesome term, but a ‘death spiral’ is a mathematical term. They say when the insurance gets so expensive, healthy people won’t buy it because they—it’s just a trade-off." He told Mr. Jean that that's what's happening with Obamacare, which is a lie. Enrollment numbers are going up and the system is not collapsing. That's just the reality.

But it’s a reality Ryan is callously denying. Here's the truth: he and his fellow Republicans are trying to take Mr. Jean's health insurance away. They're doing that without a plan in place to save his insurance, and potentially save his life. They've had six years to create a plan. If they don't have one by now, they're not going to have one. And Paul Ryan is going to own the consequences.